Individual
PAULINE PETERKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
330 SW 27TH AVE, FORT LAUDERDALE, FL 33312-2051
(954) 791-4300
Mailing address
4740 N STATE ROAD 7, LAUDERDALE LAKES, FL 33319-5839
(954) 486-4005
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
APRN1473942
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1473942
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN1473942
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1473942
ARNP
FL
05
—
766721300
—
FL
Enumeration date
04/26/2007
Last updated
10/25/2021
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