Individual
BREANNA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
911 NORTHLAND DR, PRINCETON, MN 55371
(763) 389-1313
Mailing address
400 STINSON BLVD, MINNEAPOLIS, MN 55413-2614
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
66330
MN
207Q00000X
Family Medicine Physician
2015018606
MO
207Q00000X
Family Medicine Physician
66330
MN
Other
Enumeration date
06/24/2015
Last updated
09/12/2019
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