Provider Demographics
NPI:1508529736
Name:PETERS, RAMONA (NP)
Entity Type:Individual
Prefix:MRS
First Name:RAMONA
Middle Name:
Last Name:PETERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:RAMONA
Other - Middle Name:
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:15 LAWRENCE CV
Mailing Address - Street 2:
Mailing Address - City:VALLEY GRANDE
Mailing Address - State:AL
Mailing Address - Zip Code:36703-9304
Mailing Address - Country:US
Mailing Address - Phone:133-407-4229
Mailing Address - Fax:
Practice Address - Street 1:15 LAWRENCE CV
Practice Address - Street 2:
Practice Address - City:VALLEY GRANDE
Practice Address - State:AL
Practice Address - Zip Code:36703-9304
Practice Address - Country:US
Practice Address - Phone:133-407-4229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-067218363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care