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General NPI Number Information
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NPI Number | 1184743627
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Entity Type | Individual
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Provider Name | JULIE CHRISTINE PETERSON RN, BSN
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 1650 COCHRANE CIR
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City | FT CARSON
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State | CO
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Zip | 80913-4603
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Country | US
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Telephone | 719-526-5300
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Fax | 719-524-4183
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Provider Business Mailing Address
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Address Line | 1590 PURPLE SAGE CT
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-6303
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Country | US
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Telephone | 719-526-5300
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Fax | 719-524-4183
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 129755
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License Number State | CO
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