Provider Demographics
NPI:1144061029
Name:PETERSON, BERNICE ELOHO (CPR & FIRST AID)
Entity type:Individual
Prefix:
First Name:BERNICE
Middle Name:ELOHO
Last Name:PETERSON
Suffix:
Gender:F
Credentials:CPR & FIRST AID
Other - Prefix:
Other - First Name:BERNICE
Other - Middle Name:ELOHO
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPR & FIRST AID
Mailing Address - Street 1:6353 64TH AVE APT C5
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1501
Mailing Address - Country:US
Mailing Address - Phone:202-830-7708
Mailing Address - Fax:
Practice Address - Street 1:336 RIGGS PARK PL NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-2580
Practice Address - Country:US
Practice Address - Phone:513-470-6612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant