Peterson, Eric L

Peterson, Eric L is an individual health care provider with primary practice located at 4100 Dewey St , Manitowoc WI 54220-5497. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Peterson, Eric L can be contacted via phone (920) 686-5700.

Contact Information

Primary practice address
4100 Dewey St Manitowoc WI 54220-5497
Phone: (920) 686-5700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 5433-33 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 5433-33 Wisconsin

Profile Details

NPI number 1790112050
LBN Legal business name Peterson, Eric L
Credentials MSN FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2013
Last updated Nov 30th, 2021 - about 4 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 1790112050 NPPES
Wisconsin MEDICAID 100034550

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