Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Jennifer Louise Petersen, NURSEPRACTITIONER

Individual provider Family Nurse Practitioner · NPI 1629053343

Mrs. Jennifer Louise Petersen, NURSEPRACTITIONER is a Family Nurse Practitioner in Fort Drum, New York. Licensed in Kansas. Registered with an NPI since 2005.

Licensed in
KS
In the registry since
2005

Practice location Address checks out

11050 Mount Belvedere Blvd USA Meddac Attn: Credentials
Fort Drum, NY 13602-5438
Phone: (315) 772-4025
Fax: (315) 772-9498
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 44888 (KS)

Record details

NPI number1629053343
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedDecember 15, 2005
Last updated in NPPESJuly 13, 2026

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