Individual
JEAN MARIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1973 117TH AVE NE, BLAINE, MN 55449-5467
(763) 439-7250
Mailing address
1973 117TH AVE NE, BLAINE, MN 55449-5467
(763) 439-7250
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
222160-9
MN
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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