Peterson, Pamela Teresa

Peterson, Pamela Teresa is an individual health care provider with primary practice located at 300 W Washington Ave Suite 300, Jackson MI 49201-2180. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Peterson, Pamela Teresa can be contacted via phone (517) 841-1305.

Contact Information

Primary practice address
300 W Washington Ave Suite 300 Jackson MI 49201-2180
Phone: (517) 841-1305
Fax: (517) 841-1306
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4704194081 Michigan

Profile Details

NPI number 1255371530
LBN Legal business name Peterson, Pamela Teresa
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Nov 27th, 2007 - about 18 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 1255371530 NPPES
Michigan MEDICAID 4762402
Michigan Other P00252787

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