Petersen, Jennifer Louise

Petersen, Jennifer Louise is an individual health care provider with primary practice located at 11050 Mount Belvedere Blvd Usa Meddac Attn: Credentials, Fort Drum NY 13602-5438. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Petersen, Jennifer Louise can be contacted via phone (315) 772-4025.

Contact Information

Primary practice address
11050 Mount Belvedere Blvd Usa Meddac Attn: Credentials Fort Drum NY 13602-5438
Phone: (315) 772-4025
Fax: (315) 772-9498
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 44888 Kansas

Profile Details

NPI number 1629053343
LBN Legal business name Petersen, Jennifer Louise
Credentials NURSE PRACTITIONER
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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