Individual
MRS. JESSICA LANIER PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1310 S CANNON BLVD, KANNAPOLIS, NC 28083-6233
(704) 938-7021
(704) 938-6189
Mailing address
1310 S CANNON BLVD, KANNAPOLIS, NC 28083-6233
(704) 938-7021
(704) 938-6189
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15639
NC
Other
Enumeration date
02/19/2010
Last updated
02/19/2010
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