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Susan Peterson
Primary Care Nurse Practitioner in Grosse Pointe, Michigan
NPI 1134888118

Susan Peterson is a Primary Care Nurse Practitioner based in Grosse Pointe, MI and is specialized in Primary Care. Susan Peterson practices in Grosse Pointe, MI. The NPI Number for Susan Peterson is 1134888118 and holds a License No. 4704310011 (Michigan).

The current practice location address for Susan Peterson is 447 Washington Rd, Grosse Pointe, MI and can be reached out via phone at 313-410-0155.

Location: 447 Washington Rd, Grosse Pointe, MI, 48230-1617
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Provider Profile Details
NPI Number
1134888118
Provider Name
Susan Peterson
Credential
Provider Entity Type
Individual
Gender
Female
Address
447 Washington Rd, Grosse Pointe, MI, 48230-1617
Phone Number
313-410-0155
Fax Number
Provider Enumeration Date
12/16/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4704310011 01 MI NURSING LICENSE NUMBER
institution
Provider Business Practice Location Address Details
Address
447 Washington Rd
City
State
Zip
48230-1617
Phone Number
313-410-0155
Fax Number
person
Provider Business Mailing Address Details
Address
447 Washington Rd
City
State
Zip
48230-1617
Phone Number
313-410-0155
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
License No.
4704310011 (Michigan)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
License No.
4704310011 (Michigan)
Definition
Definition to come...
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