Provider Demographics
NPI:1205496049
Name:PETERS, ANNETTE FELICIA (MPH)
Entity type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:FELICIA
Last Name:PETERS
Suffix:
Gender:F
Credentials:MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 PREFERRED PL APT 205
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7030
Mailing Address - Country:US
Mailing Address - Phone:202-374-7547
Mailing Address - Fax:
Practice Address - Street 1:5220 PREFERRED PL APT 205
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7030
Practice Address - Country:US
Practice Address - Phone:202-374-7547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH001236175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty