| NPI | 1497172399 |
|---|---|
| Former Name | JILL PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209011410) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: IL 209011410) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2021-11-15 |