NPI 1285241489

Ganielle Marva Peterson, ASSISTEDLIVINGADMN

Practitioner Nursing Home Administrator Port St Lucie, FL

Practice location

Address: 2773 SE Clareton Ter, Port St Lucie, FL 34952-6621
Phone: (954) 657-1812

Registered specialties

Nursing Home Administrator Primary

Nursing Service Related Providers Taxonomy 376G00000X

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Registry record

NPI: 1285241489
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Sep 2020
Record last updated: 30 Sep 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.