Individual
WANDA MARIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
700 CITY HALL DR, FT OGLETHORPE, GA 30742-7802
(706) 861-3387
(706) 638-5541
Mailing address
78 S ELMWOOD ST, ROSSVILLE, GA 30741-6613
(706) 861-3387
(706) 638-5541
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN077378
GA
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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