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Individual
ANDREA B PETERSON
Active
Individual
ANDREA B PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R29648
ND
363LN0000X
Neonatal Nurse Practitioner
Primary
R29648
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19930
—
ND
Enumeration date
09/05/2008
Last updated
11/17/2009
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