Healthcare Provider Details

I. General information

NPI: 1013482454
Provider Name (Legal Business Name): RITA F PETERS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2018
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4602 E UNIVERSITY DR STE 150
PHOENIX AZ
85034-7423
US

IV. Provider business mailing address

125 KINLEY HOLLOW RD
INDIAN MOUND TN
37079-5403
US

V. Phone/Fax

Practice location:
  • Phone: 480-493-3444
  • Fax: 720-598-0440
Mailing address:
  • Phone: 931-980-2912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number225351
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number225351
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberC-APN.0003184-C-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: