Individual
NICHOLE PETTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1250 SW VETERANS WAY STE 120, REDMOND, OR 97756-2588
(541) 383-3005
(541) 383-1883
Mailing address
600 SW COLUMBIA ST STE 6250, BEND, OR 97702-1099
(541) 383-3005
(541) 383-1883
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
202009378NP-PP
OR
363LF0000X
Family Nurse Practitioner
5816
CT
Other
Enumeration date
08/06/2014
Last updated
01/17/2023
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