Most Relevant Information
Provider Data
| NPI Number: | 1003691510 |
| Provider Name: | JULIANNE JOAN PETERSON |
| Entity Type: | Individual |
| Taxonomy Code: | 163WM0705X |
| Specialty: | Registered Nurse |
| License Number: | 10.174952 |
Most Important Dates
| Enumeration Date: | 08/31/2023 |
| Last Updated: | 08/31/2023 |
Provider Practice Location
365 MONTAUK AVE
NEW LONDON
CT
063204700
Practice Location Phone/Fax
| Phone: | 8604420711 |
| Fax: |
Provider Mailing Location
64 SCOTCH CAP RD UNIT 187
QUAKER HILL
CT
063751456
Provider Mailing Phone/Fax
| Phone: | 7818127869 |
| Fax: |