Doctor Name: | MRS. SARAH REPP PETERSON |
NPI Number: | 1033279369 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | A.N.P. |
License Number: | 4704222519 |
Business Practice Address: | 14650 E Old Us Highway 12 Suite 101 Chelsea, MI - 481181801 |
Business Phone Number: | 7344753979 |
Business Fax Number: | 7344334513 |
Mailing Address: | 14650 E Old Us Highway 12, Suite 101 CHELSEA |
State: | MI |
Postal Code: | 481181801 |
Phone Number: | 7344753979 |
Fax Number: | 7344334513 |
NPI Enumeration Date: | 12/08/2006 |
NPI Last Update Date: | 02/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | 4704222519 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |