Individual
ANESSA SANTIAGO PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3400 UNION AVE, SHEBOYGAN, WI 53081-8426
(920) 802-2100
Mailing address
PO BOX 735044, CHICAGO, IL 60673-2843
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11366-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100189230
—
WI
Enumeration date
11/08/2021
Last updated
12/27/2024
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