MEDICARE: RENEE L PETERS

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1689508400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE L PETERS

Provider Business Mailing Address
First Line	:	685 YALE LN
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-7251
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	685 YALE LN
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-7251
Country	:	US
Telephone Number	:	814-943-0414
Fax Number	:

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

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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Directions to “ RENEE L PETERS ” Practice Location

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