MR. LARRY L PETERSON RN NPI 1124459151

NPI Information

NPI: 1124459151
Provider Name: MR. LARRY L PETERSON, RN
Classification: Registered Nurse - 163WA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
601 S EDWIN C MOSES BLVD
DAYTON, OH
ZIP 45417
Phone: (937) 734-8333
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MR. Larry L Peterson, RN is an addiction (substance use disorder) registered nurse in Dayton, OH. MR. Larry L Peterson, RN NPI is 1124459151. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

601 S EDWIN C MOSES BLVD
DAYTON, OH
ZIP 45417-424
Phone: (937) 734-8333

The enumeration date for this NPI number is 12/2/2013 and was last updated on 10/2/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		378059	OHIO	No
2	163WH0200X	Registered Nurse	Home Health	378059	OHIO	No
3	163WP0809X	Registered Nurse	Psychiatric/Mental Health, Adult	378059	OHIO	No
4	163WA0400X	Registered Nurse	Addiction (Substance Use Disorder)	RN.378059	OHIO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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