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NPI Code Detail

MEDICARE: NATHAN PETERSON PHARMD

MEDICARE: NATHAN PETERSON PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist22482IA

General Provider Information

NPI Number : 1164013488
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN PETERSON PHARMD
Provider Business Mailing Address
First Line : 2425 MUSCATINE AVE
Second Line :
City : IOWA CITY
State : IA
Zip : 52240-6647
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2425 MUSCATINE AVE
Second Line :
City : IOWA CITY
State : IA
Zip : 52240-6647
Country : US
Telephone Number : 319-358-1056
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2021
Last Update Date : 01/29/2021

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Directions to “ NATHAN PETERSON PHARMD” Practice Location

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