Individual
RENEE P PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 BURDICK EXPY W, MINOT, ND 58701-4406
(701) 857-5124
(701) 857-3264
Mailing address
PO BOX 5010, MINOT, ND 58702-5010
(701) 857-5650
(701) 857-5031
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1132
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
R23794
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12675
—
ND
Enumeration date
11/12/2006
Last updated
12/08/2020
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