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NPI Code Detail

MEDICARE: MRS. HELEN JANE PETERSON CNP

MEDICARE: MRS. HELEN JANE PETERSON CNP
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
1363LF0000XFamily Nurse PractitionerR16233-6MN

General Provider Information

NPI Number : 1356300297
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HELEN JANE PETERSON CNP
Provider Business Mailing Address
First Line : 15327 WOOD DUCK TRL NW
Second Line :
City : PRIOR LAKE
State : MN
Zip : 55372-4514
Country : US
Telephone Number : 952-447-3735
Fax Number :
Provider Business Practice Location Address
First Line : 2300 SIOUX TRL NW
Second Line :
City : PRIOR LAKE
State : MN
Zip : 55372-9077
Country : US
Telephone Number : 952-233-4214
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. HELEN JANE PETERSON CNP” Practice Location

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