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Larry L Peterson, RN

Registered Nurse, Addiction (Substance Use Disorder) in Dayton, OH. Individual provider (NPI-1).

NPI number1124459151
StatusActive
Last updated in NPPESOct 2, 2019

Details

NPI
1124459151
Entity type
Individual (NPI-1)
Name
Mr. Larry L Peterson
Credential
RN
Sex
Male
Sole proprietor
No
Enumeration date
Dec 2, 2013
Last updated
Oct 2, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WA0400X Registered Nurse, Addiction (Substance Use Disorder)RN.378059OHYes
163W00000X Registered Nurse378059OH
163WH0200X Registered Nurse, Home Health378059OH
163WP0809X Registered Nurse, Psych/Mental Health, Adult378059OH

Practice location

601 S Edwin C Moses Blvd
Dayton, OH 45417-3424

Phone 937-734-8333

Mailing address

1716 Salem Ave
Springfield, OH 45505-4348

Phone 937-536-7636

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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Addiction (Substance Use Disorder) Registered Nurse providers in Dayton, OH

All 48 Addiction (Substance Use Disorder) Registered Nurse providers in Dayton · All 15,314 providers in Dayton

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