Provider Demographics
NPI:1558737171
Name:PETERS, KAREN (CPNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:PETERS
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25797 CONIFER RD
Mailing Address - Street 2:SUITE B110
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-9053
Mailing Address - Country:US
Mailing Address - Phone:303-838-3355
Mailing Address - Fax:
Practice Address - Street 1:25797 CONIFER RD
Practice Address - Street 2:SUITE B110
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-9053
Practice Address - Country:US
Practice Address - Phone:303-838-3355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0990923363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics