Provider Demographics
NPI:1215465000
Name:PERALTA, MARIA RAMOS (BSN, RNBC, PCCN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:RAMOS
Last Name:PERALTA
Suffix:
Gender:F
Credentials:BSN, RNBC, PCCN
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:RAMOS
Other - Last Name:PINEDA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1701 LIVE OAK TRL
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-4081
Mailing Address - Country:US
Mailing Address - Phone:619-869-0511
Mailing Address - Fax:
Practice Address - Street 1:14121 PARKE LONG CT STE 201
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1647
Practice Address - Country:US
Practice Address - Phone:855-247-1940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-24
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001242327163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse