Individual
JANETTE R. PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2333 KNOB CREEK RD, SUITE 16, JOHNSON CITY, TN 37604-2007
(423) 975-0764
(423) 975-0141
Mailing address
2333 KNOB CREEK RD, SUITE 16, JOHNSON CITY, TN 37604-2007
(423) 975-0764
(423) 975-0141
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN100385 APN7001
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3905357
—
TN
Enumeration date
09/26/2005
Last updated
02/06/2009
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