Individual
NIKIA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3143 CLIFFORD ST, PHILADELPHIA, PA 19121-2516
(267) 979-5707
Mailing address
267 E BRINGHURST ST, PHILADELPHIA, PA 19144-1719
(267) 235-4243
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN274000
PA
Other
Enumeration date
01/15/2018
Last updated
01/15/2018
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