Carr Peterson, Mary T
Carr Peterson, Mary T is an individual health care provider with primary practice located at 1410 Sw Tradition Dr Ste 120 , Ankeny IA 50023-9188. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Carr Peterson, Mary T can be contacted via phone (515) 875-9040.Contact Information
Primary practice address
1410 Sw Tradition Dr Ste 120
Ankeny IA 50023-9188
Phone: (515) 875-9040
Fax: (515) 875-9041
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 001597 | Iowa |
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 001597 | Iowa |
Profile Details
NPI number | 1164496212 |
---|---|
LBN Legal business name | Carr Peterson, Mary T |
Credentials | Physician Assistant (PA) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 15th, 2006 |
Last updated | Dec 29th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1164496212 | NPPES |
Other | 37904 | WELLMARK | |
MEDICAID | 0634600 | WELLMARK | |
MEDICAID | 1117994 | WELLMARK | |
Other | 37902 | WELLMARK | |
Other | 37903 | WELLMARK | |
Other | 37905 | WELLMARK | |
MEDICAID | 2117994 | WELLMARK | |
MEDICAID | 3117994 | WELLMARK |
Popular Providers
-
Lozano, Christa Therese
800 E 1St St Suite 1700, Ankeny IA 50021-2077 -
Karabias, John W
1410 Sw Tradition Dr Ste 110 , Ankeny IA 50023 -
Olson, John Harrison
800 E 1St St Suite 1700, Ankeny IA 50021-2077 -
Taylor, Holland Joy
120 Nw 36Th St , Ankeny IA 50023-8411 -
Hovick, Brooke D
350 Ne 36Th St , Ankeny IA 50021-6728 -
Tigges, Andrew E
1410 Sw Tradition Dr Ste 110 , Ankeny IA 50023 -
Witzenburg, Kristin R.
1410 Sw Tradition Dr Ste 110 , Ankeny IA 50023-9188 -
Mitchell, Brandon Michael
120 Nw 36Th St , Ankeny IA 50023-8411