Individual
KEVIN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 HARVARD ST SE, MINNEAPOLIS, MN 55455-0363
(612) 273-3000
Mailing address
5309 34TH PL N, MINNEAPOLIS, MN 55422-2819
(605) 728-7450
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2418
MN
Other
Enumeration date
09/20/2019
Last updated
03/26/2020
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