Petersen, Emily Lara

Petersen, Emily Lara is an individual health care provider with primary practice located at 700 W Ironwood Dr Ste 375 , Coeur D Alene ID 83814-4401. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is her primary health care specialty. Petersen, Emily Lara can be contacted via phone (208) 625-6100.

Contact Information

Primary practice address
700 W Ironwood Dr Ste 375 Coeur D Alene ID 83814-4401
Phone: (208) 625-6100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 6027146-1205 Utah
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X M-11299 Idaho

Profile Details

NPI number 1750414447
LBN Legal business name Petersen, Emily Lara
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 13th, 2007
Last updated Oct 6th, 2020 - about 4 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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