Individual
MARY ELLEN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C-ANP
Contact information
Practice address
W12070 STATE HWY 35, STOCKHOLM, WI 54769-6127
(715) 821-8532
(715) 442-2351
Mailing address
W12070 STATE HWY 35, STOCKHOLM, WI 54769-6127
(715) 821-8532
(715) 442-2351
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0360774
MN
363LA2200X
Adult Health Nurse Practitioner
4576-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0404556
MEDICA
MN
01
—
090M9PE
BLUE CROSS BLUE SHIELD
MN
05
—
243994800
—
MN
Enumeration date
08/01/2006
Last updated
04/07/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us