Doctor Name: | MS. ERIN PETERSON |
NPI Number: | 1245329846 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN-BC |
License Number: | 209006152 |
Business Practice Address: | 559 Vincent Street Attn: 21 Mdos/sgof - Family Practice Peterson Afb, CO - 809141540 |
Business Phone Number: | 7195562273 |
Business Fax Number: | 8668677926 |
Mailing Address: | 559 Vincent Street, Attn: 21 Mdos/sgof - Family Practice PETERSON AFB |
State: | CO |
Postal Code: | 809141540 |
Phone Number: | 7195562273 |
Fax Number: | 8668677926 |
NPI Enumeration Date: | 10/12/2006 |
NPI Last Update Date: | 06/25/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 209006152 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |