Provider Demographics
NPI:1326370362
Name:PEALER, THELMA JANE (NP)
Entity Type:Individual
Prefix:
First Name:THELMA
Middle Name:JANE
Last Name:PEALER
Suffix:
Gender:F
Credentials:NP
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:CLARKSVILLE HEALTH AND REHAB CENTER
Mailing Address - Street 2:184 BUFFALO RD
Mailing Address - City:CLARKSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23927-1139
Mailing Address - Country:US
Mailing Address - Phone:434-206-3100
Mailing Address - Fax:434-374-4491
Practice Address - Street 1:CLARKSVILLE HEALTH AND REHAB CENTER
Practice Address - Street 2:184 BUFFALO RD
Practice Address - City:CLARKSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23927-1139
Practice Address - Country:US
Practice Address - Phone:434-206-3100
Practice Address - Fax:434-374-4491
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2023-11-06
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024 168675363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1326370362Medicaid