| NPI | 1790914604 |
|---|---|
| Former Name | DANA ALICE PETERSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN200031) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 203502) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2017-01-11 |