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NPI Code Detail

MEDICARE: MS. ANN KATHRYN PETERSON N.P.

MEDICARE:  MS. ANN KATHRYN PETERSON  N.P.
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
1363L00000XNurse Practitioner60227030WI

General Provider Information

NPI Number : 1811019672
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANN KATHRYN PETERSON N.P.
Provider Business Mailing Address
First Line : 9424 WILSON BLVD
Second Line :
City : WAUWATOSA
State : WI
Zip : 53226-1742
Country : US
Telephone Number : 414-302-9958
Fax Number :
Provider Business Practice Location Address
First Line : 2239 S 108TH ST
Second Line :
City : WEST ALLIS
State : WI
Zip : 53227-1107
Country : US
Telephone Number : 414-541-2772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2007
Last Update Date : 05/24/2013

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Directions to “ MS. ANN KATHRYN PETERSON N.P.” Practice Location

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