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General NPI Number Information
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NPI Number | 1942649090
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Entity Type | Organization
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Legal Business Name | NORMA PETERS HEALTH CARE
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Dates
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Enumeration Date | 06/21/2013
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Last Update Date | 06/21/2013
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Provider Practice Location Address
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Address Line | 2024 COLLIER CIR W
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City | DECATUR
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State | GA
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Zip | 30032-5456
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Country | US
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Telephone | 678-773-8023
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Fax |
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Provider Business Mailing Address
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Address Line | 2024 COLLIER CIR W
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City | DECATUR
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State | GA
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Zip | 30032-5456
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Country | US
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Telephone | 678-773-8023
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Fax |
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Authorized Official
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Title or Position | RIGESTERED NURSE
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Name | CARMEN IONIE BARTLEY
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Credential |
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Telephone | 678-773-8023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HC576022
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | RN178119
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1558656728
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License Number State | OK
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