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NPI Code Detail

MEDICARE: MRS. KATIE E PETERSON CNM

MEDICARE: MRS. KATIE E PETERSON CNM
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
1367A00000XAdvanced Practice MidwifeAPRN9466077FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295176063
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATIE E PETERSON CNM
Provider Business Mailing Address
First Line : 2701 W DR MARTIN LUTHER KING JR BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33607-6303
Country : US
Telephone Number : 813-684-2229
Fax Number : 813-816-0326
Provider Business Practice Location Address
First Line : 2701 W DR MARTIN LUTHER KING JR BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33607-6303
Country : US
Telephone Number : 813-684-2229
Fax Number : 813-816-0326
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2013
Last Update Date : 06/07/2022

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Directions to “ MRS. KATIE E PETERSON CNM” Practice Location

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