NICOLE M PETERSON

URBANA, IL
NPI1538479571
Former NameNICOLE M ALLRED
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IL  085003809)
Enumeration Date2010-10-08
Last Update Date2016-03-22
Business Address
-- NICOLE M PETERSON PA
611 W PARK ST ED
URBANA, IL 61801-2500
Phone number: 217-383-3313
Mailing Address
-- NICOLE M PETERSON PA
611 W. PARK ST. BWPC
URBANA, IL 61801-2500
Phone number: 217-383-6792