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Individual
KELLY LEIGH PETERSON
Active
Individual
KELLY LEIGH PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-AC
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
19462
TN
Other
Enumeration date
01/16/2015
Last updated
02/22/2016
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