Provider Demographics
NPI:1225341282
Name:PETERSON, AMBER MARIE (MS)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:MARIE
Last Name:PETERSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:MARIE
Other - Last Name:ARTZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 CENTRA CARE CIRCLE, #1300
Mailing Address - Street 2:CENTRA CARE CLINIC WOMEN'S & CHILDRENS/PEDIATRICS
Mailing Address - City:ST CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-5000
Mailing Address - Country:US
Mailing Address - Phone:320-654-3610
Mailing Address - Fax:
Practice Address - Street 1:1900 CENTRA CARE CIRCLE, #1300
Practice Address - Street 2:CENTRA CARE CLINIC WOMEN'S & CHILDRENS/PEDIATRICS
Practice Address - City:ST CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-5000
Practice Address - Country:US
Practice Address - Phone:320-654-3610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS