| Doctor Name: | LAURA PETERSEN |
| NPI Number: | 1538524285 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | ARNP2514342 |
| Business Practice Address: | 1413 Nw 23rd Ave Chiefland, FL - 32626 |
| Business Phone Number: | 3524939393 |
| Business Fax Number: | |
| Mailing Address: | 7650 Se 64th St, NEWBERRY |
| State: | FL |
| Postal Code: | 326697188 |
| Phone Number: | 3524726158 |
| Fax Number: | |
| NPI Enumeration Date: | 12/23/2015 |
| NPI Last Update Date: | 12/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | ARNP2514342 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |