Individual
JANE M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN196717
OH
363LW0102X
Women's Health Nurse Practitioner
Primary
COA.02264.NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3069683
—
OH
Enumeration date
06/09/2010
Last updated
09/18/2014
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