MEDICARE: ANGELA PETERS APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	137242	WI
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	086693-23	NH

General Provider Information

NPI Number	:	1669859005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA PETERS APRN

Provider Business Mailing Address
First Line	:	15 CONSTITUTION DR OFC 113
Second Line	:
City	:	BEDFORD
State	:	NH
Zip	:	03110-6042
Country	:	US
Telephone Number	:	603-718-3939
Fax Number	:	603-583-4913

Provider Business Practice Location Address
First Line	:	15 CONSTITUTION DR OFC 113
Second Line	:
City	:	BEDFORD
State	:	NH
Zip	:	03110-6042
Country	:	US
Telephone Number	:	603-718-3939
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2015
Last Update Date	:	04/08/2026

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