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General NPI Number Information
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NPI Number | 1780989590
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Entity Type | Individual
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Provider Name | HOANG KIM PETERSEN NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 01/26/2011
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 16728 E SMOKY HILL RD UNIT 10D
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City | CENTENNIAL
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State | CO
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Zip | 80015-2400
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Country | US
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Telephone | 303-766-7006
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Fax | 303-766-1023
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Provider Business Mailing Address
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Address Line | 2550 N THUNDERBIRD CIR STE 303
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City | MESA
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State | AZ
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Zip | 85215-1219
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Country | US
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Telephone | 480-455-4932
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Fax | 480-776-0025
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 1649
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License Number State | TX
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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 | NP-10342
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License Number State | CO
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