Healthcare Provider Details

I. General information

NPI: 1356017636
Provider Name (Legal Business Name): CHRISTY L PEELER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTY L LETCHWORTH

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 CENTERVILLE RD STE 5400
TALLAHASSEE FL
32308-4654
US

IV. Provider business mailing address

4634 BASSWOOD RD
GREENWOOD FL
32443-1830
US

V. Phone/Fax

Practice location:
  • Phone: 850-877-0101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11014714
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: