Individual
TERRYE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CDE
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-5952
Mailing address
312 E 16TH ST, COSTA MESA, CA 92627-3257
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
458154
CA
Other
Enumeration date
01/28/2011
Last updated
07/16/2012
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