Individual
AMANDA JANE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1351 W CENTRAL PARK AVE, DAVENPORT, IA 52804-1853
(563) 421-1900
(563) 421-1809
Mailing address
1351 W CENTRAL PARK AVE, DAVENPORT, IA 52804-1853
(563) 421-1900
(563) 421-1809
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041511033
IL
163W00000X
Registered Nurse
132137
IA
363LF0000X
Family Nurse Practitioner
209023700
IL
363LF0000X
Family Nurse Practitioner
Primary
A165003
IA
Other
Enumeration date
12/28/2016
Last updated
09/28/2023
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