JERREKA PETERSON AGACNP NPI 1104415827

NPI Information

NPI: 1104415827
Provider Name: JERREKA PETERSON, AGACNP
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
4901 E PATRICK HENRY HWY
BURKEVILLE, VA
ZIP 23922
Phone: (804) 766-3027
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Jerreka Peterson, AGACNP is an acute care nurse practitioner in Burkeville, VA with 4 years of experience. Jerreka Peterson, AGACNP NPI is 1104415827. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4901 E PATRICK HENRY HWY
BURKEVILLE, VA
ZIP 23922-454
Phone: (804) 766-3027

The NPI 1104415827 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/17/2021 and was last updated on 12/5/2023.

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	363LA2100X	Nurse Practitioner	Acute Care	0024180529	VIRGINIA	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: 5/5/2024

NPI Synchronization or Removal

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