Provider Demographics
NPI:1437624459
Name:PETERSON, KAREN (FNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:PETERSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ACADEMY STREET
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-2902
Mailing Address - Country:US
Mailing Address - Phone:828-536-5125
Mailing Address - Fax:828-536-5112
Practice Address - Street 1:88 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777-8943
Practice Address - Country:US
Practice Address - Phone:828-765-6101
Practice Address - Fax:828-765-2383
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5011085363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily