Provider Demographics
NPI:1124876065
Name:PEELE, CHRISTINA MARIA
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIA
Last Name:PEELE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 NASH ST W STE A
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-3744
Mailing Address - Country:US
Mailing Address - Phone:252-200-4145
Mailing Address - Fax:
Practice Address - Street 1:509 NASH ST W STE A
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-3744
Practice Address - Country:US
Practice Address - Phone:252-200-4145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
NCE-400174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist