Petersen, Susan R

Petersen, Susan R is an sole proprietor health care provider with primary practice located at 237 26Th St , Ogden UT 84401-3105. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Petersen, Susan R can be contacted via phone (801) 625-3700.

Contact Information

Primary practice address
237 26Th St Ogden UT 84401-3105
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 177248-3102 Utah

Profile Details

NPI number 1740452226
LBN Legal business name Petersen, Susan R
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 25th, 2008
Last updated May 5th, 2008 - about 17 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 1740452226 NPPES
Utah Other 260022408 RAILROAD MEDICARE
Utah MEDICAID 876000308007 RAILROAD MEDICARE

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