Provider Demographics
NPI:1164727202
Name:PETERS, MARGARET ANN
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:ANN
Last Name:PETERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 WEST MAIN SUITE C
Mailing Address - Street 2:
Mailing Address - City:TRUMANN
Mailing Address - State:AR
Mailing Address - Zip Code:72472
Mailing Address - Country:US
Mailing Address - Phone:870-483-0068
Mailing Address - Fax:870-483-0066
Practice Address - Street 1:809 WEST MAIN SUITE C
Practice Address - Street 2:
Practice Address - City:TRUMANN
Practice Address - State:AR
Practice Address - Zip Code:72472
Practice Address - Country:US
Practice Address - Phone:870-483-0068
Practice Address - Fax:870-483-0066
Is Sole Proprietor?:No
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator