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1144719527
STACY ANNE PETERSEN
COSTA MESA, CA
NPI
1144719527
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA NP95007971)
Enumeration Date
2018-05-01
Last Update Date
2018-05-01
Business Address
STACY ANNE PETERSEN FNP-C
700 W 19TH ST
COSTA MESA, CA 92627-3517
Phone number: 949-645-4646
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Mailing Address
STACY ANNE PETERSEN FNP-C
29 TERRACE CIR
LAGUNA NIGUEL, CA 92677-4112
Phone number: 949-514-5228
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