Provider Demographics
NPI:1184954877
Name:PETERMAN-PINSON, EARLA VON (RN,BSN)
Entity type:Individual
Prefix:MRS
First Name:EARLA
Middle Name:VON
Last Name:PETERMAN-PINSON
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:MRS
Other - First Name:EARLA
Other - Middle Name:VON
Other - Last Name:PETERMAN-PINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN,BSN
Mailing Address - Street 1:3824 COLUMBINE PL
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-5101
Mailing Address - Country:US
Mailing Address - Phone:937-718-0371
Mailing Address - Fax:
Practice Address - Street 1:3824 COLUMBINE PL
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-5101
Practice Address - Country:US
Practice Address - Phone:937-718-0371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-03
Last Update Date:2010-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 329976163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse