Peterson, Kelli Ann

Peterson, Kelli Ann is an individual health care provider with primary practice located at 73265 Confederated Way , Pendleton OR 97801. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Peterson, Kelli Ann can be contacted via phone (541) 966-9830.

Contact Information

Primary practice address
73265 Confederated Way Pendleton OR 97801
Phone: (541) 966-9830
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 200843278RN Oregon

Profile Details

NPI number 1225276124
LBN Legal business name Peterson, Kelli Ann
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2009
Last updated Jan 30th, 2009 - about 15 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 1225276124 NPPES
Oregon MEDICAID 171037

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