Individual
SHERRY LEE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1400 E KINCAID ST, MOUNT VERNON, WA 98274-4127
(360) 428-6434
(360) 848-4233
Mailing address
1400 E KINCAID ST, C/O CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP60076546
WA
363LF0000X
Family Nurse Practitioner
Primary
AP60076546
WA
Other
Enumeration date
02/18/2009
Last updated
10/21/2021
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