Individual
MICHELLE KAY PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
813 CHESTNUT AVE, DIXON, IL 61021-3802
(815) 719-2625
Mailing address
813 CHESTNUT AVE, DIXON, IL 61021-3802
(815) 719-2625
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
06/27/2025
Last updated
06/27/2025
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