Organization
PINE RUN MENTAL HEALTH & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID C PETERSEN NP (PMHNP)
(570) 929-2277
Entity
Organization
Contact information
Practice address
400 MARKET ST, WILLIAMSPORT, PA 17701-6344
(929) 724-2277
(929) 724-2277
Mailing address
2319 PINE RUN RD, LINDEN, PA 17744-8149
(929) 724-2277
(929) 724-2277
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/30/2024
Last updated
09/30/2024
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