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Individual

MRS. CAROL JEAN PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, BSN

Contact information

Practice address
2215 FULLER RD, 11A, ANN ARBOR, MI 48105-2303
(734) 769-7100
(734) 845-3225
Mailing address
2215 FULLER RD, 11A, ANN ARBOR, MI 48105-2303
(734) 769-7100
(734) 845-3225

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704221602
MI

Other

Enumeration date
09/16/2009
Last updated
09/16/2009
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