Peterson, Kelly Rae

Peterson, Kelly Rae is an individual health care provider with primary practice located at 9803 Vagabond Ln N , Maple Grove MN 55311-1364. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Peterson, Kelly Rae can be contacted via phone (612) 242-1341.

Contact Information

Primary practice address
9803 Vagabond Ln N Maple Grove MN 55311-1364
Phone: (612) 242-1341
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 88989 Minnesota

Profile Details

NPI number 1336424027
LBN Legal business name Peterson, Kelly Rae
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2011
Last updated Jan 26th, 2012 - about 12 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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