Individual
CHARITY FAITH PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
814 N 11TH ST, MONTEVIDEO, MN 56265-1629
(320) 269-2222
Mailing address
705 STATE RD, MONTEVIDEO, MN 56265-2210
(320) 226-9724
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
820913
MN
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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