Peterson, Adaline Lee

Peterson, Adaline Lee is an individual health care provider with primary practice located at 146 W Dale St Suite 102, Waterloo IA 50703-1901. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, which is considered as her primary health care specialty. Peterson, Adaline Lee can be contacted via phone (319) 235-5086.

Contact Information

Primary practice address
146 W Dale St Suite 102 Waterloo IA 50703-1901
Phone: (319) 235-5086
Fax: (319) 235-5107
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X F-034796 Iowa

Profile Details

NPI number 1124005236
LBN Legal business name Peterson, Adaline Lee
Credentials A.R.N.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2005
Last updated Jul 9th, 2007 - 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 1124005236 NPPES
Iowa MEDICAID 2419234
Iowa MEDICAID 0419234
Iowa MEDICAID 3419234

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