Individual
SARAH GEORGINE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP,ARNP,FNP-C
Contact information
Practice address
107 NORTH RIVER STREET, SUITE B, ENTERPRISE, OR 97828-1633
(541) 263-1225
Mailing address
901 E GREENWOOD ST, ENTERPRISE, OR 97828-1633
(541) 263-1225
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
202101745NP-PP
OR
363LF0000X
Family Nurse Practitioner
202201745NP-PP
OR
363LP2300X
Primary Care Nurse Practitioner
202201745NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202101745NP-PP
AANP
OR
01
—
F01211016
AANP
OR
01
—
UNKNOWN
WALLOWA MEMORIAL HOSPITAL
OR
Enumeration date
02/24/2021
Last updated
03/25/2022
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