Petersen, Kristy L

Petersen, Kristy L is an individual health care provider with primary practice located at 540 The Rialto , Venice FL 34285-2900. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Petersen, Kristy L can be contacted via phone (941) 486-6927.

Contact Information

Primary practice address
540 The Rialto Venice FL 34285-2900
Fax: (941) 486-6931
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X ARNP9335906 Florida

Profile Details

NPI number 1003313115
LBN Legal business name Petersen, Kristy L
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2018
Last updated Apr 6th, 2018 - about 7 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 1003313115 NPPES
Florida Other ARNP9335906 ARNP LICENSE

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