Individual
KRISTY L PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
540 THE RIALTO, VENICE, FL 34285-2900
(941) 486-6927
(941) 486-6931
Mailing address
PO BOX 850001, ORLANDO, FL 32885-0001
(941) 486-6927
(941) 486-6931
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
ARNP9335906
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ARNP9335906
ARNP LICENSE
FL
Enumeration date
04/06/2018
Last updated
04/06/2018
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