Petersen, Timothy Lou

Petersen, Timothy Lou is an individual health care provider with primary practice located at 1836 South Ave , La Crosse WI 54601-5429. He recently has only one registered license in Nursing Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Petersen, Timothy Lou can be contacted via phone (608) 775-3969.

Contact Information

Primary practice address
1836 South Ave La Crosse WI 54601-5429
Phone: (608) 775-3969
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Addiction (Substance Use Disorder) 163WA0400X 83542-30 Wisconsin

Profile Details

NPI number 1275030892
LBN Legal business name Petersen, Timothy Lou
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2018
Last updated Apr 10th, 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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