MR. LARRY L PETERSON RN NPI 1124459151

NPI Information

  • NPI: 1124459151
  • Provider Name: MR. LARRY L PETERSON, RN
  • Classification: Registered Nurse - 163WA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 601 S EDWIN C MOSES BLVD
    DAYTON, OH
    ZIP 45417
  • Phone: (937) 734-8333

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NPI Details

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
1163W00000XRegistered Nurse378059OHIONo
2163WH0200XRegistered NurseHome Health378059OHIONo
3163WP0809XRegistered NursePsychiatric/Mental Health, Adult378059OHIONo
4163WA0400XRegistered NurseAddiction (Substance Use Disorder)RN.378059OHIOYes

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: 11/21/2025

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