CORENE R PETERSON — Medicare Enrolled Provider (PRACTITIONER - CLINICAL SOCIAL WORKER, ID)
CORENE R PETERSON — Medicare Enrolled Provider (PRACTITIONER - CLINICAL SOCIAL WORKER, ID) is one of 9,000 enrolled providers in the MedicareEnroll dataset. Key details — Name: CORENE R PETERSON; Type: Individual; NPI: 1003188897.
| Name | CORENE R PETERSON |
|---|---|
| Type | Individual |
| NPI | 1003188897 |
| Provider type | PRACTITIONER - CLINICAL SOCIAL WORKER |
| State | ID |
| Enrollment ID | I20140919002390 |
| Multiple NPI flag | N |
| Source | CMS Medicare FFS Public Provider Enrollment (PECOS) |
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