| NPI | 1497132864 |
|---|---|
| Former Name | MAUREEN RUTH PETERSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN164545) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN164545) |
| 363LF0000X Nurse Practitioner, Family (Licence: NH 065390-23) | |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2022-12-29 |