NPI | 1245994839 |
---|---|
Former Name | MERIDITH PETERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 25657) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC AG10210066) |
Enumeration Date | 2021-10-28 |
Last Update Date | 2025-07-28 |