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General NPI Number Information
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NPI Number | 1245329846
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Entity Type | Individual
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Provider Name | ERIN PETERSON APRN-BC
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Gender | Female
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 06/25/2010
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Provider Practice Location Address
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Address Line | 559 VINCENT STREET ATTN: 21 MDOS/SGOF - FAMILY PRACTICE
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City | PETERSON AFB
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State | CO
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Zip | 80914-1540
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Country | US
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Telephone | 719-556-2273
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Fax | 866-867-7926
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Provider Business Mailing Address
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Address Line | 559 VINCENT STREET ATTN: 21 MDOS/SGOF - FAMILY PRACTICE
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City | PETERSON AFB
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State | CO
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Zip | 80914-1540
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Country | US
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Telephone | 719-556-2273
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Fax | 866-867-7926
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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 | 209006152
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License Number State | IL
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