Individual
JENNIE L PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC, FNP
Contact information
Practice address
6032 40TH AVE, KENOSHA, WI 53142-7018
(262) 287-1999
(262) 287-0884
Mailing address
6032 40TH AVE, KENOSHA, WI 53142-7018
(262) 287-1999
(262) 287-0884
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
3146
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2022152805
WI
Other
Enumeration date
07/31/2007
Last updated
04/11/2024
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