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General NPI Number Information
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NPI Number | 1144379116
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Entity Type | Individual
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Provider Name | CHRISTINE JANE PETERSON NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 6455 S YOSEMITE ST 6TH FLOOR
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-5139
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Country | US
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Telephone | 303-718-2964
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Fax |
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Provider Business Mailing Address
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Address Line | 4003 W 119TH MEWS
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City | WESTMINSTER
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State | CO
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Zip | 80031-5027
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Country | US
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Telephone | 720-315-5612
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0004628
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 99490
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License Number State | CO
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