Individual
LAURA PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1413 NW 23RD AVE, CHIEFLAND, FL 32626
(352) 493-9393
Mailing address
7650 SE 64TH ST, NEWBERRY, FL 32669-7188
(352) 472-6158
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP2514342
FL
Other
Enumeration date
12/23/2015
Last updated
12/23/2015
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