Individual
JADEN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6501 N 19TH AVE, PHOENIX, AZ 85015-1646
(602) 795-6020
Mailing address
7301 N 16TH ST STE 102, PHOENIX, AZ 85020-5266
(480) 420-4027
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN316201
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
328674
AZ
Other
Enumeration date
07/30/2024
Last updated
09/11/2025
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