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General NPI Number Information
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NPI Number | 1548087778
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Entity Type | Organization
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Legal Business Name | DR. JEN PETERS PLLC
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Dates
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Enumeration Date | 09/19/2024
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 880 LOCUST ST STE 129
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City | DUBUQUE
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State | IA
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Zip | 52001-6700
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Country | US
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Telephone | 563-590-7009
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Fax |
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Provider Business Mailing Address
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Address Line | 530 CANDLEWICK CT
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City | DUBUQUE
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State | IA
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Zip | 52003-8589
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Country | US
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Telephone | 563-590-7009
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER PETERS
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Credential |
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Telephone | 563-590-7009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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