Individual
DR. JESSICA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
211 NE 54TH ST STE 201, KANSAS CITY, MO 64118-4330
(816) 453-6777
(816) 454-3601
Mailing address
2670 RETRIEVER DR, CLERMONT, FL 34711-5488
(954) 257-4158
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2022031193
MO
2084P0800X
Psychiatry Physician
DOS-1955
HI
2084P0800X
Psychiatry Physician
Primary
OS14979
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OS14979
DOH MQA
FL
Enumeration date
06/04/2014
Last updated
05/01/2025
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