Individual provider · Type 1 NPI
Debra Antoinette Petersen, NURSE PRACTITIONER
Family Nurse Practitioner · Hammond, IN
NPI number
1417039652
Active
Practice location
7131 Indianapolis Blvd
Hammond, IN 46324
Mailing address
8918 Blaine Pl
Crown Point, IN 46307-8102
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 28063616A (IN) |
Family Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1417039652
Debra Antoinette Petersen, NURSE PRACTITIONER's National Provider Identifier is 1417039652, issued on Oct 19, 2006. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Hammond, IN. The record was last updated on Jul 8, 2007.