Individual
MR. CASEY ALLEN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 365-1000
Mailing address
420 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0341
(612) 365-1000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R 147870-9
MN
Other
Enumeration date
02/14/2013
Last updated
08/28/2019
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