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1205548443
MICHELLE ANNMARIE JACKSON PETERSEN
ASTORIA, NY
NPI
1205548443
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NY F348339-01)
Enumeration Date
2022-12-20
Last Update Date
2024-10-30
Business Address
Mrs. MICHELLE ANNMARIE JACKSON PETERSEN NP
2322 30TH RD STE 1A
ASTORIA, NY 11102-3238
Phone number: 667-326-9198
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Mailing Address
Mrs. MICHELLE ANNMARIE JACKSON PETERSEN NP
21917 130TH DR
SPRINGFIELD GARDENS, NY 11413-1220
Phone number: 718-276-2651
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