Individual
JERREKA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
524 SOUTHPARK BLVD, COLONIAL HEIGHTS, VA 23834-3609
(804) 504-7980
(804) 554-5387
Mailing address
524 SOUTHPARK BLVD, COLONIAL HEIGHTS, VA 23834-3609
(804) 504-7980
(804) 554-5387
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024180529
VA
Other
Enumeration date
01/17/2021
Last updated
09/23/2025
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