Individual
MARISSA LYNN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CNM
Contact information
Practice address
242 S COASTAL HWY, MIDWAY, GA 31320-5231
(912) 272-0778
(866) 583-4671
Mailing address
242 S COASTAL HWY, MIDWAY, GA 31320-5231
(912) 575-6100
(866) 583-4671
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN300285
GA
367A00000X
Advanced Practice Midwife
Primary
RN300285
GA
Other
Enumeration date
09/24/2019
Last updated
11/16/2025
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