Doctor Name: | SUSAN MARY PETERSON |
NPI Number: | 1003854217 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 82551 |
Business Practice Address: | 20600 Milton Ct Brookfield, WI - 530454020 |
Business Phone Number: | 2627842849 |
Business Fax Number: | |
Mailing Address: | 20600 Milton Ct, BROOKFIELD |
State: | WI |
Postal Code: | 530454020 |
Phone Number: | 2627842849 |
Fax Number: | |
NPI Enumeration Date: | 06/02/2006 |
NPI Last Update Date: | 04/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WH0200X |
License Number: | 82551 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Home Health |
Taxonomy Definition: |