Peterson, Nicole M

Peterson, Nicole M is an individual health care provider with primary practice located at 611 W Park St Ed, Urbana IL 61801-2500. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Peterson, Nicole M can be contacted via phone (217) 383-3313.

Contact Information

Primary practice address
611 W Park St Ed Urbana IL 61801-2500
Phone: (217) 383-3313
Fax: (217) 383-4014
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085003809 Illinois

Profile Details

NPI number 1538479571
LBN Legal business name Peterson, Nicole M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 8th, 2010
Last updated Mar 22nd, 2016 - about 10 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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