Individual provider · Type 1 NPI

Crystal Peterson

Licensed Practical Nurse · St. Louis, MO

NPI number 1073057352 Active

Practice location

4066 Dunnica Ave
St. Louis, MO 63116-3510

Mailing address

1601 Old South River Rd
St. Charles, MO 63303-4120

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X2015028944 (MO)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1073057352

Crystal Peterson's National Provider Identifier is 1073057352, issued on Dec 6, 2016. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in St. Louis, MO. The record was last updated on Jul 28, 2022.