Individual
AMANDA MAE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, WHNP-BC
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8148
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8148
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
26738
TN
Other
Enumeration date
03/13/2020
Last updated
03/30/2026
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