Individual
NANCY PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
259 1ST ST, MINEOLA, NY 11501-3957
(516) 404-8974
Mailing address
259 1ST ST, MINEOLA, NY 11501-3957
(516) 663-0333
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
308222
NY
Other
Enumeration date
01/27/2022
Last updated
08/30/2022
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