Female

Miss Lora J. Peterson PA-C

Medical Physician Assistant in Jacksonville, FL(View on Map)

Full Name

Miss Lora Jean Peterson PA-C

NPI Number

1487333548

NPI Type

Individual Provider

Gender

Female

Enumeration Date

07/17/2023

Specialties

(Taxonomies)

Code

363AM0700X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

PA9114289

Contact
Information

Purpose

Mailing
Location

Address

15555 SPOTTED SADDLE CIR
1697 KINGS RD

City

Jacksonville
Jacksonville

State

FL
FL

Postal Code

32218-7984
32209-6169

Country

US
US

Telephone Number

(510) 875-9909
(904) 478-5483

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/17/2023

Provider Address

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