| Doctor Name: | JO A PETERSON |
| NPI Number: | 1073584371 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | WHCNP |
| License Number: | R090431-3 |
| Business Practice Address: | 310 Belle Ave Mankato, MN - 560015287 |
| Business Phone Number: | 5073875581 |
| Business Fax Number: | |
| Mailing Address: | 617 Baker Ave, MANKATO |
| State: | MN |
| Postal Code: | 560012502 |
| Phone Number: | 5073453287 |
| Fax Number: | |
| NPI Enumeration Date: | 01/27/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | R090431-3 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |