Individual
MRS. JENNIFER LYNN PETERSON
Active
Individual
MRS. JENNIFER LYNN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
041369391
IL
363LF0000X
Family Nurse Practitioner
Primary
209.017872
IL
Other
Enumeration date
04/18/2018
Last updated
03/23/2023
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