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General NPI Number Information
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NPI Number | 1023399474
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Entity Type | Individual
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Provider Name | KATHERINE RENEE PETERSEN RPH
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Gender | Female
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Dates
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Enumeration Date | 08/30/2011
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Last Update Date | 08/30/2011
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Provider Practice Location Address
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Address Line | 12 MAIN ST
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City | EPPING
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State | NH
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Zip | 03042-2425
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Country | US
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Telephone | 603-679-5839
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Fax |
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Provider Business Mailing Address
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Address Line | 24 MORGAN DR
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City | EPPING
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State | NH
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Zip | 03042-2542
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Country | US
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Telephone | 603-734-4290
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 19652
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | R2191
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License Number State | NH
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