Provider Demographics
NPI:1225659949
Name:PETERS, ALEXIS (ARNP)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:PETERS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:CHALMERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 808
Mailing Address - Street 2:
Mailing Address - City:CHEWELAH
Mailing Address - State:WA
Mailing Address - Zip Code:99109-0808
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:518 E CLAY AVE
Practice Address - Street 2:
Practice Address - City:CHEWELAH
Practice Address - State:WA
Practice Address - Zip Code:99109-8947
Practice Address - Country:US
Practice Address - Phone:509-935-8424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60567412163W00000X
261QF0400X
WAAP61078503363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)