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Individual

CRYSTAL M PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
400 CELEBRATION PL, CELEBRATION, FL 34747-4970
(407) 975-0406
(407) 975-0407
Mailing address
1832 MERRIVALE LOOP, OCOEE, FL 34761-5215
(516) 528-5779

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
APRN11002022
FL
367A00000X
Advanced Practice Midwife
Primary
APRN11002022
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103732800
FL
Enumeration date
12/03/2012
Last updated
02/01/2023
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