Individual
JEANNE LOUISE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
30 LUNA DR, BUFFALO, WY 82834-8910
(307) 250-9122
(866) 652-1064
Mailing address
1414 W 4TH ST, GILLETTE, WY 82716-3328
(307) 682-6263
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
824
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23337.0824
CERTIFIED NURSE MIDWIFE
WY
Enumeration date
09/26/2006
Last updated
03/07/2023
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