Individual
MRS. MARSHA JEAN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
W1697 CTH B, MARINETTE, WI 54143-9454
(715) 732-0383
Mailing address
W1697 CTH B, MARINETTE, WI 54143-9454
(715) 732-0383
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
24485-031
WI
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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