Individual
CRAIG ALAN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-2000
Mailing address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-2000
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
173873-30
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
173873-30
WI
Other
Enumeration date
06/30/2018
Last updated
12/23/2020
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