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NPI Code Detail

MEDICARE: ELIZABETH PETERSON

MEDICARE: ELIZABETH PETERSON
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1346640612
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH PETERSON
Provider Business Mailing Address
First Line : 1813 CHEYENNE AVE
Second Line :
City : LOVELAND
State : CO
Zip : 80538-4244
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1813 CHEYENNE AVE
Second Line :
City : LOVELAND
State : CO
Zip : 80538-4244
Country : US
Telephone Number : 970-820-2292
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2014
Last Update Date : 07/19/2016

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Directions to “ ELIZABETH PETERSON ” Practice Location

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