Individual
ANDREA MARGO PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
Mailing address
620 8TH AVE N, SAINT CLOUD, MN 56303-3532
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6029
MN
Other
Enumeration date
08/02/2018
Last updated
08/02/2018
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