Angela Peterson
Nurse Practitioner - Family Medicine
12266 De Paul Dr Ste 205
Bridgeton
, Missouri 63044-2514
Angela Peterson
Nurse Practitioner - Family Medicine
12266 De Paul Dr Ste 205
Bridgeton
, Missouri 63044-2514
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About
Features
Specialties
- Nurse Practitioner - Family Medicine
Languages spoken
- English
Location
First Address
- Angela Peterson
- Po Box 955534
- Saint Louis, MO
- Zip : 63195-5534
- Phone :
Second Address
- Angela Peterson
- 12266 De Paul Dr Ste 205
- Bridgeton, MO
- Zip : 63044-2514
- Phone : (314) 218-2300
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LF0000X | Nurse Practitioner - Family Medicine | 2017028749 | MO |
National Provider Identifier
| NPI | 1003271586 |
|---|---|
| Provider Name | Angela Peterson |
| First Address | Saint Louis, MO 63195-5534 |
| Second Address | Bridgeton, MO 63044-2514 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/12/2015 |
| Last Update Date | 10/11/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.