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General NPI Number Information
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NPI Number | 1366635385
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Entity Type | Individual
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Provider Name | CARMEN PETERS LVN
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Gender | Female
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 08/22/2007
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Provider Practice Location Address
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Address Line | 4680 MERITAGE CT
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City | GILROY
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State | CA
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Zip | 95020-8849
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Country | US
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Telephone | 408-826-4225
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Fax |
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Provider Business Mailing Address
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Address Line | 606 SKYLARK DR
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City | SUISUN CITY
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State | CA
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Zip | 94585-2225
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Country | US
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Telephone | 707-422-5435
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | VN215599
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | VN215599
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License Number State | CA
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