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Individual

MS. DEBRA THERESA PETERSON I

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
38454 N CAROLINA AVE, SAN TAN VALLEY, AZ 85140-5835
(480) 882-3520
Mailing address
1359 W DIAMOND AVE, APACHE JUNCTION, AZ 85120-6377
(480) 275-9774

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
LP042742
AZ

Other

Enumeration date
08/23/2013
Last updated
10/21/2015
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