Individual
JESSICA ANN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
940 E 3RD ST STE 205, CASPER, WY 82601-3251
(307) 577-4260
Mailing address
1902 GARDEN CREEK RD, CASPER, WY 82601-6638
(307) 851-3606
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
50280
WY
Other
Enumeration date
07/06/2022
Last updated
07/06/2022
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