Individual
CARRIE M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6500 EXCELSIOR BLVD, METHODIST HOSPITAL, ST LOUIS PARK, MN 55426-4702
(952) 993-5222
(952) 993-6499
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R 126897-7
MN
367500000X
Certified Registered Nurse Anesthetist
1329
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
6679
NC
Other
Enumeration date
01/11/2006
Last updated
09/10/2021
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