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Individual

AMANDA JOAN PETERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN/CRNA

Contact information

Practice address
DULUTH CLINIC, 400 EAST THIRD STREET, DULUTH, MN 55805-1951
(218) 786-8364
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-4222

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA2273
MN

Other

Enumeration date
12/06/2018
Last updated
12/31/2018
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