Provider Demographics
NPI:1093503468
Name:PETERSON, IRION FERRYMAE (FNP)
Entity type:Individual
Prefix:MS
First Name:IRION
Middle Name:FERRYMAE
Last Name:PETERSON
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 BUSHS LN
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-7990
Mailing Address - Country:US
Mailing Address - Phone:615-681-0127
Mailing Address - Fax:
Practice Address - Street 1:204 BUSHS LN
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-7990
Practice Address - Country:US
Practice Address - Phone:615-681-0127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38306363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily