| Kelly Peterson, APRN | |
|
3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | |
| (210) 916-4863 | |
| Not Available |
| Full Name | Kelly Peterson |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 3551 Roger Brooke Dr, Fort Sam Houston, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639787872 | NPI | - | NPPES |
| 1124390253 | Other | DOD ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 1130715 (Texas) | Primary |
| 171000000X | Military Health Care Provider | (* (Not Available)) | Secondary |
| Entity Name | Central Texas Intensivists Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205690765 PECOS PAC ID: 8921446345 Enrollment ID: O20240404001976 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Peterson, APRN 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 Ph: (210) 539-9582 | Kelly Peterson, APRN 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 Ph: (210) 916-4863 |
Anastasiya Zemtsova, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234 Phone: 210-916-7500 | |
Cathy Darlene Cotton, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3851 Roger Brooke Dr, Mche-qd (credentials), Fort Sam Houston, TX 78234 Phone: 210-916-2460 | |
Jessa Perry, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234 Phone: 210-539-9582 | |
Leanne Putnam, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234 Phone: 210-539-9582 | |
Hannah Morales, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234 Phone: 210-916-3000 | |
Allen Ward Magnone, ACNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234 Phone: 210-916-4141 | |
Julia M Ceremuga, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3851 Roger Brooke Dr, Mche-qd (credentials), Fort Sam Houston, TX 78234 Phone: 210-916-5554 Fax: 210-916-2121 |