| NPI | 1497172399 |
|---|---|
| Former Name | JILL PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist Adult Health (Licence: IL 209011410) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209011410) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2025-03-24 |