Provider Demographics
NPI:1245329846
Name:PETERSON, ERIN (APRN-BC)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:
Last Name:PETERSON
Suffix:
Gender:F
Credentials:APRN-BC
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Mailing Address - Street 1:559 VINCENT STREET
Mailing Address - Street 2:ATTN: 21 MDOS/SGOF - FAMILY PRACTICE
Mailing Address - City:PETERSON AFB
Mailing Address - State:CO
Mailing Address - Zip Code:80914-1540
Mailing Address - Country:US
Mailing Address - Phone:719-556-2273
Mailing Address - Fax:866-867-7926
Practice Address - Street 1:559 VINCENT STREET
Practice Address - Street 2:ATTN: 21 MDOS/SGOF - FAMILY PRACTICE
Practice Address - City:PETERSON AFB
Practice Address - State:CO
Practice Address - Zip Code:80914-1540
Practice Address - Country:US
Practice Address - Phone:719-556-2273
Practice Address - Fax:866-867-7926
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2010-06-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL209006152363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily