Individual provider · Type 1 NPI

Michelle Annmarie Jackson Petersen, NP

Family Nurse Practitioner · Astoria, NY

NPI number 1205548443 Active

Practice location

2322 30th Rd Ste 1A
Astoria, NY 11102-3238

Call (667) 326-9198 Map

Mailing address

21917 130th Dr
Springfield Gardens, NY 11413-1220

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XF348339-01 (NY)

Family Nurse Practitioner: Definition to come...

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About NPI 1205548443

Michelle Annmarie Jackson Petersen, NP's National Provider Identifier is 1205548443, issued on Dec 20, 2022. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Astoria, NY. The record was last updated on Oct 30, 2024.