Individual
MRS. WENDY R PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
7015 HIGHWAY 190 EAST SERVICE RD STE 102, COVINGTON, LA 70433-4960
(985) 893-9592
(985) 318-1004
Mailing address
7015 HIGHWAY 190 EAST SERVICE RD STE 102, COVINGTON, LA 70433-4960
(985) 893-9592
(985) 318-1004
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP07310
LA
363LF0000X
Family Nurse Practitioner
R860436
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02078279
—
MS
05
—
2345940
—
LA
Enumeration date
10/29/2008
Last updated
01/24/2020
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