Individual
JENNIFER M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2000 MEDICAL PKWY STE 510, ANNAPOLIS, MD 21401-3747
(410) 897-0822
(410) 897-0095
Mailing address
2000 MEDICAL PKWY STE 510, ANNAPOLIS, MD 21401-3747
(410) 897-0822
(410) 897-0095
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R201261
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R201261
LICENSE NUMBER
MD
Enumeration date
07/25/2019
Last updated
02/15/2023
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