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Tanya Peterson
NPI 1770943862 · on the registry since 2016
Practice
- Address
- 805 Leonard St Ne
Grand Rapids, MI 49503 - Phone
- (616) 284-5879
- Organisation at this address
- D.A. Blodgett - St. John'S
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 58
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2016-03-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan