Peterson, Jodi M

Peterson, Jodi M is an individual health care provider with primary practice located at 1919 E Thomas Rd , Phoenix AZ 85016-7710. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Peterson, Jodi M can be contacted via phone (602) 933-0970.

Contact Information

Primary practice address
1919 E Thomas Rd Phoenix AZ 85016-7710
Phone: (602) 933-0970
Fax: (602) 933-0068
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X AP3321 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X AP3321 Arizona

Profile Details

NPI number 1942440763
LBN Legal business name Peterson, Jodi M
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2009
Last updated Mar 26th, 2018 - about 6 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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Identifiers

StateTypeNumberIssuer
All States NPI 1942440763 NPPES
Arizona MEDICAID 423317

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