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1538479571
NICOLE M PETERSON
URBANA, IL
NPI
1538479571
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Former Name
NICOLE M ALLRED
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085003809)
Enumeration Date
2010-10-08
Last Update Date
2016-03-22
Business Address
-- NICOLE M PETERSON PA
611 W PARK ST ED
URBANA, IL 61801-2500
Phone number: 217-383-3313
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Mailing Address
-- NICOLE M PETERSON PA
611 W. PARK ST. BWPC
URBANA, IL 61801-2500
Phone number: 217-383-6792
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