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General NPI Number Information
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NPI Number | 1235987819
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Entity Type | Organization
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Legal Business Name | PETERSON HEALTH AND WELLNESS
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Dates
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Enumeration Date | 05/09/2024
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 56 STARDUST RD UNIT 3
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City | BURNSVILLE
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State | NC
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Zip | 28714-6385
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Country | US
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Telephone | 828-284-0166
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Fax |
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Provider Business Mailing Address
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Address Line | 56 STARDUST RD UNIT 3
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City | BURNSVILLE
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State | NC
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Zip | 28714-6385
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Country | US
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Telephone | 828-203-8820
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Fax | 855-576-5013
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | EMILY PITMAN
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Credential |
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Telephone | 828-203-8820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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