Ellery-Peterson, Rhonda Sue

Ellery-Peterson, Rhonda Sue is an individual health care provider with primary practice located at 801 Joe Mann Blvd , Midland MI 48642-8900. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Ellery-Peterson, Rhonda Sue can be contacted via phone (989) 794-4032.

Contact Information

Primary practice address
801 Joe Mann Blvd Midland MI 48642-8900
Phone: (989) 794-4032
Fax: (989) 354-4979
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4704177958 Michigan

Profile Details

NPI number 1376525170
LBN Legal business name Ellery-Peterson, Rhonda Sue
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated Oct 26th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376525170 NPPES
Michigan Other 4704177958 STATE LICENSE NUMBER
Michigan MEDICAID 4975205 STATE LICENSE NUMBER
Michigan Other 500Z410370 STATE LICENSE NUMBER

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