Petersen, Geneva A.
Petersen, Geneva A. is an individual health care provider with primary practice located at 1505 Eastland Dr Ste 2200 , Bloomington IL 61701-7910. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Petersen, Geneva A. can be contacted via phone (309) 454-3456.Contact Information
Primary practice address
1505 Eastland Dr Ste 2200
Bloomington IL 61701-7910
Phone: (309) 454-3456
Fax: (309) 454-6977
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 209-004837 | Illinois |
Profile Details
| NPI number | 1750321667 |
|---|---|
| LBN Legal business name | Petersen, Geneva A. |
| Credentials | Certified Nurse Practitioner (CNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2006 |
| Last updated | Apr 29th, 2021 - about 4 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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