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General NPI Number Information
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NPI Number | 1851241616
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Entity Type | Individual
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Provider Name | JORDAN PETERS
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Gender |
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 4048 LAUREL ST
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City | ANCHORAGE
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State | AK
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Zip | 99508-5389
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Country | US
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Telephone | 902-223-3879
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 866
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City | HAVERHILL
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State | MA
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Zip | 01831-1066
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Country | US
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Telephone | 978-994-3096
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 249739
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License Number State | AK
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