Individual
JENNIFER S PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
41433-020
WI
207NS0135X
Procedural Dermatology Physician
41433-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1040967
PHYSICIANS PLUS
WI
05
—
34220800
—
WI
01
—
9990
DEAN HEALTH INSURANCE
WI
Enumeration date
04/19/2006
Last updated
01/07/2015
Update your record
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