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Individual
SUSAN PETERSON
Active
Individual
SUSAN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PHN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60210392
WA
163WC1500X
Community Health Registered Nurse
Primary
34747
AK
Other
Enumeration date
05/05/2015
Last updated
05/05/2015
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