Individual
MRS. HANNAH KALEIGH PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
123 WEDGEWOOD DR, COLUMBIA, IL 62236-1052
(618) 281-2233
(618) 281-2244
Mailing address
123 WEDGEWOOD DR, COLUMBIA, IL 62236-1052
(618) 281-2233
(618) 281-2244
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2012007085
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
2017036299
MO
Other
Enumeration date
01/23/2018
Last updated
02/14/2021
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