Individual
JENNIFER PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-C
Contact information
Practice address
315 S SETH CHILD RD, MANHATTAN, KS 66502-3003
(785) 776-2813
(785) 776-2851
Mailing address
315 S SETH CHILD RD, MANHATTAN, KS 66502-3003
(785) 776-2318
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-77876-072
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53-77876-072
STATE LICENSE
KS
Enumeration date
09/14/2017
Last updated
09/11/2023
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