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Individual

LENA CAROLINE PETERSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1225 E CENTERTON BLVD, CENTERTON, AR 72719-1225
(479) 795-1301
(479) 795-1304
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
(314) 543-6979

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
716670-1
NY
363LF0000X
Family Nurse Practitioner
Primary
230416
AR
363LF0000X
Family Nurse Practitioner
342629
NY

Other

Enumeration date
06/24/2017
Last updated
03/06/2025
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