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Individual

LORI JEAN PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1752 DORSET LN, NEW RICHMOND, WI 54017-2452
(715) 246-8365
(715) 246-8298
Mailing address
1752 DORSET LN, NEW RICHMOND, WI 54017-2452
(715) 246-8365
(715) 246-8298

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
121689-30
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
363LW0102X
TAXONOMY
WI
Enumeration date
09/06/2006
Last updated
03/25/2016
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