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Individual
MRS. KRISTEN JEANELLE PETERSON
Active
Individual
MRS. KRISTEN JEANELLE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT017683
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025221
MEDICARE GROUP
PA
05
—
1016314280001
—
PA
05
—
1016314280002
—
PA
01
—
104392
UPMC
PA
01
—
118111
MEDICARE GROUP
PA
01
—
1762971
HIGHMARK
PA
01
—
1983093
HIGHMARK GROUP
PA
01
—
220033
HEALTH AMERICA/HEALTH ASSURANC
PA
01
—
548783
HIGHMARK GROUP
PA
01
—
579C
UPMC
PA
01
—
724159
HELATH AMERICA/HEATH ASSURANCE
PA
Enumeration date
01/18/2006
Last updated
04/17/2015
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