Petersen, Denise K

Petersen, Denise K is an individual health care provider with primary practice located at 11234 Anderson St #1617, Loma Linda CA 92354-2804. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Petersen, Denise K can be contacted via phone (909) 558-8591.

Contact Information

Primary practice address
11234 Anderson St #1617 Loma Linda CA 92354-2804
Phone: (909) 558-8591
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP12031 California

Profile Details

NPI number 1386663805
LBN Legal business name Petersen, Denise K
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386663805 NPPES
California MEDICAID RN566951

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