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General NPI Number Information
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NPI Number | 1386497667
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Entity Type | Individual
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Provider Name | KATHERINE FRANCES PETERS AGNP
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Gender | Female
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Dates
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Enumeration Date | 04/08/2024
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 3111 GUNDERSEN DR
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City | ONALASKA
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State | WI
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Zip | 54650-8447
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Country | US
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Telephone | 608-775-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 SOUTH AVE
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City | LA CROSSE
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State | WI
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Zip | 54601-5467
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Country | US
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Telephone | 608-782-7300
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 14657-33
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 14657-33
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License Number State | WI
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