Provider Demographics
NPI:1356098016
Name:PETERKIN, ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:PETERKIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 CASTLEPOINTE DR
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-3825
Mailing Address - Country:US
Mailing Address - Phone:252-363-3665
Mailing Address - Fax:
Practice Address - Street 1:3421 N ROXBORO ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-3257
Practice Address - Country:US
Practice Address - Phone:919-680-1540
Practice Address - Fax:919-680-1541
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30797183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist