Provider Demographics
NPI:1013482454
Name:PETERS, RITA F (APRN)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:F
Last Name:PETERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:125 KINLEY HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:INDIAN MOUND
Mailing Address - State:TN
Mailing Address - Zip Code:37079-5403
Mailing Address - Country:US
Mailing Address - Phone:931-980-2912
Mailing Address - Fax:
Practice Address - Street 1:4602 E UNIVERSITY DR STE 150
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-7423
Practice Address - Country:US
Practice Address - Phone:480-493-3444
Practice Address - Fax:720-598-0440
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-12
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN225351363LA2200X, 363LG0600X
COC-APN.0003184-C-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology