Individual
CASEY ELIZABETH PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
15022 BUTTERBOUGH LN, FORT WAYNE, IN 46814-8833
(260) 445-5646
(651) 237-8774
Mailing address
3512 STELLHORN RD, FORT WAYNE, IN 46815-4631
(260) 445-5646
(651) 237-8774
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71009322A
IN
Other
Enumeration date
09/05/2019
Last updated
09/05/2023
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