| NPI | 1679837926 |
|---|---|
| Former Name | CASSIDY MARIE PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN C3062) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R1741300) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN CNP3062) | |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2024-11-04 |