Individual
ASHLEY ANNE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
30011 E STATE HIGHWAY 51, COWETA, OK 74429-7681
(918) 486-2161
Mailing address
6600 S YALE AVE, SUITE 1400, TULSA, OK 74136-3347
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
29052
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2009
Last updated
07/02/2012
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