Petersen, Hoang Kim

Petersen, Hoang Kim is an individual health care provider with primary practice located at 16728 E Smoky Hill Rd Unit 10D , Centennial CO 80015-2400. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Petersen, Hoang Kim can be contacted via phone (303) 766-7006.

Contact Information

Primary practice address
16728 E Smoky Hill Rd Unit 10D Centennial CO 80015-2400
Phone: (303) 766-7006
Fax: (303) 766-1023
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 1649 Texas
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NP-10342 Colorado

Profile Details

NPI number 1780989590
LBN Legal business name Petersen, Hoang Kim
Credentials NURSE PRACTITIONER
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2011
Last updated Mar 17th, 2018 - about 6 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 1780989590 NPPES
Texas MEDICAID 283185101
Texas MEDICAID 283185102
Texas MEDICAID 78459834
Texas MEDICAID 283185104
Texas MEDICAID 200342180 A
Texas MEDICAID 283185103

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