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General NPI Number Information
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NPI Number | 1003611690
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Entity Type | Organization
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Legal Business Name | JULIE PETERS WOUND PRACTITIONER, LLC
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Dates
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Enumeration Date | 02/17/2025
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 11 N SOHO PL
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City | CHANDLER
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State | AZ
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Zip | 85225-5721
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Country | US
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Telephone | 480-223-3061
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Fax |
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Provider Business Mailing Address
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Address Line | 1525 S HIGLEY RD STE 104 PMB 2556
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City | GILBERT
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State | AZ
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Zip | 85296
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Country | US
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Telephone | 480-734-8261
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | JULIE MARIE PETERS
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Credential | FNP-BC
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Telephone | 480-734-8261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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