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1568713543
IDELLA PETERSON
DETROIT, MI
NPI
1568713543
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: MI 4704143291)
Enumeration Date
2012-10-01
Last Update Date
2012-10-01
Business Address
Mrs. IDELLA PETERSON RN
2925 RUSSELL ST
DETROIT, MI 48207-4825
Phone number: 313-396-5300
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Mailing Address
Mrs. IDELLA PETERSON RN
18751 BAINBRIDGE DR
SOUTHFIELD, MI 48076-5313
Phone number: 248-941-3965
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