Healthcare Provider Details

I. General information

NPI: 1265028500
Provider Name (Legal Business Name): EMILY PETERMEIER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2020
Last Update Date: 12/20/2020
Certification Date: 12/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 W PLEASANT RIDGE RD
ARLINGTON TX
76016-4427
US

IV. Provider business mailing address

5900 W PLEASANT RIDGE RD
ARLINGTON TX
76016-4427
US

V. Phone/Fax

Practice location:
  • Phone: 817-478-6041
  • Fax:
Mailing address:
  • Phone: 817-478-6041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP145768
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: