Individual
MANDEE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
300 PINELLAS ST, CLEARWATER, FL 33756-3804
(727) 462-7000
Mailing address
1701 CENTRAL AVE UNIT 575, ST PETERSBURG, FL 33713-8992
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9454708
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
11023841
FL
367500000X
Certified Registered Nurse Anesthetist
147010
FL
Other
Enumeration date
12/15/2022
Last updated
01/23/2023
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