Individual
MICHELLE ASHLEY EDWARDS PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
2761 W KENT DR, CHANDLER, AZ 85224-3904
(000) 000-0000
Mailing address
2761 W KENT DR, CHANDLER, AZ 85224-3904
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
220223
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528589
—
AZ
Enumeration date
12/17/2018
Last updated
10/25/2023
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