Individual
BRIANNE LUISA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
5220 BELFORT RD STE 130, JACKSONVILLE, FL 32256-6018
(904) 446-3686
(904) 446-3032
Mailing address
5220 BELFORT RD STE 130, JACKSONVILLE, FL 32256-6018
(904) 446-3686
(904) 446-3032
Taxonomy
Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
ARNP9215209
FL
363L00000X
Nurse Practitioner
Primary
ARNP9215209
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000848800
—
FL
05
—
309069419A
—
GA
01
—
P00718850
MEDICARE RAILROAD
—
Enumeration date
02/17/2009
Last updated
02/07/2020
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