Provider Demographics
NPI:1124917471
Name:PETERSON, MARIA (PARAMEDIC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:PETERSON
Suffix:
Gender:F
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:596 BUNCOMBE WHEELDON RD
Mailing Address - Street 2:
Mailing Address - City:EUBANK
Mailing Address - State:KY
Mailing Address - Zip Code:42567-7623
Mailing Address - Country:US
Mailing Address - Phone:606-425-7744
Mailing Address - Fax:
Practice Address - Street 1:596 BUNCOMBE WHEELDON RD
Practice Address - Street 2:
Practice Address - City:EUBANK
Practice Address - State:KY
Practice Address - Zip Code:42567-7623
Practice Address - Country:US
Practice Address - Phone:606-425-7744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1122198146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic