# KATHLEEN PETERMAN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083732093
- **Authorized official:** MS. KATHLEEN ELLEN PETERMAN LPN (LPN)
- **Authorized official phone:** (772) 225-5777

## Contact information

- **Practice address:** 611 S SEAS, JENSEN BEACH, FL 34957-5341
- **Practice address phone:** (772) 225-5777
- **Mailing address:** 611 S SEAS, JENSEN BEACH, FL 34957-5341
- **Mailing address phone:** (772) 225-5777

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 372600000X | Adult Companion | PN931913 | FL | Yes |

## Other

- **Enumeration date:** 03/27/2007
- **Last updated:** 08/22/2020