Individual
NICOLE MARIE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2251 N SHORE DR, RHINELANDER, WI 54501
(800) 866-8673
Mailing address
139 MONTCLAIR DR, CARY, IL 60013-1829
(847) 322-9331
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209.015918
IL
363LF0000X
Family Nurse Practitioner
Primary
209.015918
IL
Other
Enumeration date
04/13/2017
Last updated
07/30/2018
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