Peterson, Kim A

Peterson, Kim A is an sole proprietor health care provider with primary practice located at 1116 Elizabeth Ave , Marinette WI 54143-2515. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Peterson, Kim A can be contacted via phone (715) 732-2509.

Contact Information

Primary practice address
1116 Elizabeth Ave Marinette WI 54143-2515
Phone: (715) 732-2509
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X Wisconsin

Profile Details

NPI number 1144408048
LBN Legal business name Peterson, Kim A
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 4th, 2008
Last updated Feb 4th, 2008 - about 16 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 1144408048 NPPES
Wisconsin MEDICAID 35052300

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