Individual
MRS. JOANN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1005 LUJAN HILL RD, LAS CRUCES, NM 88007-6304
(575) 523-4573
Mailing address
1005 LUJAN HILL RD, LAS CRUCES, NM 88007-6304
(575) 523-4573
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
209833
TX
Other
Enumeration date
02/13/2020
Last updated
02/13/2020
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