Individual
ADALINE LEE PETERSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
A.R.N.P.
Contact information
Practice address
146 W DALE ST, SUITE 102, WATERLOO, IA 50703-1901
(319) 235-5086
(319) 235-5107
Mailing address
146 W DALE ST, SUITE 102, WATERLOO, IA 50703-1901
(319) 235-5086
(319) 235-5107
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
F-034796
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0419234
—
IA
05
—
2419234
—
IA
05
—
3419234
—
IA
Enumeration date
12/29/2005
Last updated
07/09/2007
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