Individual provider · NPI-1
Peter M Abraham, RN
Registered Nurse, Gerontology · Berea, KY
NPI number1679351936
StatusActive
Last updated in NPPESAug 25, 2026
Details
- NPI
- 1679351936
- Entity type
- Individual (NPI-1)
- Name
- Peter M Abraham
- Credential
- RN
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 18, 2023
- Certification date
- Aug 25, 2026
- Last updated
- Aug 25, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WG0600X | Registered Nurse, Gerontology | 4031876 | KY | Yes |
| 163W00000X | Registered Nurse | 4031876 | KY | |
| 163WC1600X | Registered Nurse, Continuing Education/Staff Development | 4031876 | KY | |
| 163WP0000X | Registered Nurse, Pain Management | 4031876 | KY | |
| 163WH1000X | Registered Nurse, Hospice | 4031876 | KY | |
| 163WC0400X | Registered Nurse, Case Management | 4031876 | KY |
Practice location
1000 Moonlight DrBerea, KY 40403-9239
Phone 610-858-4761
Mailing address
1000 Moonlight DrBerea, KY 40403-9239
Phone 859-452-0354
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