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NPI Code Detail

MEDICARE: ASHLYN KAY PETERSON PA

MEDICARE: ASHLYN KAY PETERSON PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantMN

General Provider Information

NPI Number : 1154050292
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLYN KAY PETERSON PA
Provider Business Mailing Address
First Line : 111 17TH AVE E STE 101
Second Line :
City : ALEXANDRIA
State : MN
Zip : 56308-5274
Country : US
Telephone Number : 320-762-1144
Fax Number : 320-762-1935
Provider Business Practice Location Address
First Line : 111 17TH AVE E STE 101
Second Line :
City : ALEXANDRIA
State : MN
Zip : 56308-5274
Country : US
Telephone Number : 320-762-1144
Fax Number : 320-762-1935
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2022
Last Update Date : 01/05/2026

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Directions to “ ASHLYN KAY PETERSON PA” Practice Location

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