Peterson, Angela Kelly

Peterson, Angela Kelly is an individual health care provider with primary practice located at 8740 Rivers Avenue , North Charleston SC 29406. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Peterson, Angela Kelly can be contacted via phone (843) 572-5990.

Contact Information

Primary practice address
8740 Rivers Avenue North Charleston SC 29406
Phone: (843) 572-5990
Fax: (843) 552-4121
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 642 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 642 South Carolina

Profile Details

NPI number 1861721391
LBN Legal business name Peterson, Angela Kelly
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 11th, 2009
Last updated Aug 28th, 2015 - about 10 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 1861721391 NPPES
South Carolina MEDICAID 1805PA

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