STACEY RAE PETERSEN

DES MOINES, IA
NPI1306568654
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner Family
(Licence: IA  A171201)
Enumeration Date2022-09-14
Last Update Date2023-12-08
Business Address
STACEY RAE PETERSEN NURSE PRACTITIONER
899 E 12TH STREET APT 9453
DES MOINES, IA 50304-5030
Phone number: 712-541-1949
Mailing Address
STACEY RAE PETERSEN NURSE PRACTITIONER
714 LINCOLN ST NE
LE MARS, IA 51031-3311
Phone number: 712-546-7871
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