Provider Demographics
NPI:1043549751
Name:PETERS, TERRI LYNN (BSC, RPH)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:LYNN
Last Name:PETERS
Suffix:
Gender:F
Credentials:BSC, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 BRIGHTSEAT RD
Mailing Address - Street 2:95 OFFICE PARK
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4250
Mailing Address - Country:US
Mailing Address - Phone:301-386-0857
Mailing Address - Fax:301-386-0859
Practice Address - Street 1:1835 BRIGHTSEAT RD
Practice Address - Street 2:95 OFFICE PARK
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-4250
Practice Address - Country:US
Practice Address - Phone:301-386-0857
Practice Address - Fax:301-386-0859
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist