Individual
JUDY L PETERSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CNNP CPNP
Contact information
Practice address
347 NORTH SMITH AVE, CHILDRENS SPECIALTY CLINIC NICU, ST PAUL, MN 55102
(651) 220-6210
(651) 220-7777
Mailing address
2910 CENTRE POINTE DR, 35-121A CHILDRENS HEALTH CARE, ROSEVILLE, MN 55113
(651) 855-2327
(651) 855-2310
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
R1013148
MN
363LN0005X
Critical Care Neonatal Nurse Practitioner
R1013148
MN
363LP0200X
Pediatric Nurse Practitioner
Primary
R1013148
MN
Other
Enumeration date
05/02/2006
Last updated
09/11/2025
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