Provider Demographics
NPI:1265766802
Name:PETERS, ERIN M (FNP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:PETERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 SW ARCHER RD BOX 100296
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0296
Mailing Address - Country:US
Mailing Address - Phone:352-627-9350
Mailing Address - Fax:352-273-9054
Practice Address - Street 1:1600 SW ARCHER RD BOX 100296
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-2187
Practice Address - Country:US
Practice Address - Phone:352-627-9350
Practice Address - Fax:352-273-9054
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA189815363L00000X
TN14389363L00000X
FLARNP9462934363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4342581OtherBCBS
TN1515298Medicaid
FL022835200Medicaid