Individual
MS. CORIE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
16815 E JEFFERSON AVE STE 120, GROSSE POINTE, MI 48230-1923
(586) 498-4400
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1848
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704399838
MI
363LF0000X
Family Nurse Practitioner
APRN.CNP.020746
OH
Other
Enumeration date
05/04/2017
Last updated
10/30/2023
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