Individual
JENNIFER MARIE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
1892 BASSETT RD, WESTLAKE, OH 44145-1909
(440) 465-7124
Mailing address
1892 BASSETT RD, WESTLAKE, OH 44145-1909
(440) 465-7124
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN.CNP.020810
OH
363LG0600X
Gerontology Nurse Practitioner
APRN.CNP.020810
OH
Other
Enumeration date
08/08/2017
Last updated
09/01/2022
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