Peterson, Jennifer C

Peterson, Jennifer C is an individual health care provider with primary practice located at 1836 South Ave , La Crosse WI 54601-5429. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is her primary health care specialty. Peterson, Jennifer C can be contacted via phone (608) 782-7300.

Contact Information

Primary practice address
1836 South Ave La Crosse WI 54601-5429
Phone: (608) 782-7300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 13205 North Dakota
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 075484 Georgia
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 71077 Arizona
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 53734 Wisconsin

Profile Details

NPI number 1154586071
LBN Legal business name Peterson, Jennifer C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2008
Last updated Jul 1st, 2024 - about last year

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 1154586071 NPPES
North Dakota MEDICAID 81315

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