TYSHEANA PETERSON

Homemaker

Active Individual
NPI: 1154930527

Practice Address

6717 SOUTHERN OAKS DR
Jacksonville, FL 32244

Phone: (904) 575-5082

Specialties

Specialty Code Primary License
Chore Provider 372500000X No -
Home Health Aide 374U00000X No -
Homemaker 376J00000X Yes 236899 (FL)

Frequently Asked Questions

NPI 1154930527 is the National Provider Identifier for TYSHEANA PETERSON, a Homemaker provider located in Jacksonville, FL. This NPI was enumerated on July 30, 2020.
TYSHEANA PETERSON practices at 6717 SOUTHERN OAKS DR, Jacksonville, FL 32244.

Quick Facts

NPI
1154930527
Type
Individual
Enumerated
Jul 30, 2020
Last Updated
Sep 17, 2021

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