Provider Demographics
NPI:1831477397
Name:PETERSON, DAVID (ARNP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:PETERSON
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 NORTHLAKE CT APT 210
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-5176
Mailing Address - Country:US
Mailing Address - Phone:561-670-7871
Mailing Address - Fax:561-556-4752
Practice Address - Street 1:714 NORTHLAKE COURT 210
Practice Address - Street 2:
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-5421
Practice Address - Country:US
Practice Address - Phone:561-670-7871
Practice Address - Fax:561-556-4752
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLRN2629912363LF0000X
FLAPRN2629912363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily