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Individual

GENA SUSAN PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
100 FLORENCE AVE, DONALSONVILLE, GA 39845-1135
(229) 524-5217
(229) 524-6038
Mailing address
358 GRIMSLEY RD, COLQUITT, GA 39837-7436
(229) 400-1976

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RN123548
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN126548
GA

Other

Enumeration date
02/11/2019
Last updated
03/21/2019
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