MEDICARE: LOUISE B PEELE PNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	300014	NC

General Provider Information

NPI Number	:	1588703672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUISE B PEELE PNP

Provider Business Mailing Address
First Line	:	303 GREEN ST E
Second Line	:
City	:	WILSON
State	:	NC
Zip	:	27893-4105
Country	:	US
Telephone Number	:	252-443-7744
Fax Number	:	252-443-7611

Provider Business Practice Location Address
First Line	:	8282 SOUTH NC 58 HIGHWAY
Second Line	:
City	:	ELM CITY
State	:	NC
Zip	:	27822-3805
Country	:	US
Telephone Number	:	252-443-7744
Fax Number	:	252-443-7611

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	01/04/2010

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Directions to “ LOUISE B PEELE PNP” Practice Location

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