Peterson, Jeannie Marie

Peterson, Jeannie Marie is an individual health care provider with primary practice located at 1102 W 32Nd St , Joplin MO 64804-3503. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Peterson, Jeannie Marie can be contacted via phone (417) 347-1111.

Contact Information

Primary practice address
1102 W 32Nd St Joplin MO 64804-3503
Phone: (417) 347-1111
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 55028 Kansas

Profile Details

NPI number 1992775506
LBN Legal business name Peterson, Jeannie Marie
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Apr 24th, 2024 - about 2 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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Identifiers

StateTypeNumberIssuer
All States NPI 1992775506 NPPES
Oklahoma MEDICAID 100787980A
Oklahoma MEDICAID 915240105
Oklahoma MEDICAID 100389550D
Oklahoma Other 430061375

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