Provider Demographics
NPI:1467348797
Name:PETERKIN-BYRD, MAUREEN YVONNE (RN)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:YVONNE
Last Name:PETERKIN-BYRD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 SHADY LEAF DR
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-6130
Mailing Address - Country:US
Mailing Address - Phone:813-420-2969
Mailing Address - Fax:
Practice Address - Street 1:1725 SHADY LEAF DR
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-6130
Practice Address - Country:US
Practice Address - Phone:813-420-2969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1851342163WH0200X, 163W00000X, 163WH1000X, 163WP0200X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WP0200XNursing Service ProvidersRegistered NursePediatrics