Individual
ANDRIA JO PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2400 W 49TH ST, SIOUX FALLS, SD 57105-6581
(605) 312-8700
(605) 312-8700
Mailing address
2400 W 49TH ST, SIOUX FALLS, SD 57105-6581
(605) 312-8700
(605) 312-8700
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
CP001529
SD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CP001529
SD
Other
Enumeration date
02/04/2019
Last updated
06/10/2019
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