Provider Demographics
NPI:1225219124
Name:PETERSON, FRANCES BAKER (RD)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:BAKER
Last Name:PETERSON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 LOVEJOY RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-4521
Mailing Address - Country:US
Mailing Address - Phone:978-470-2479
Mailing Address - Fax:
Practice Address - Street 1:39 LOVEJOY RD
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-4521
Practice Address - Country:US
Practice Address - Phone:978-470-2479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA401133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered