Individual
MS. MARY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
460 AMHERST ST, NASHUA, NH 03063-1220
(603) 883-7970
(603) 595-3652
Mailing address
PO BOX 808, NASHUA, NH 03061-0808
(603) 595-2997
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0390
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3073371
—
NH
Enumeration date
12/19/2005
Last updated
10/22/2019
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