Individual
GARY C PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
482 ADAMS AVE, AKRON, CO 80720-1149
(970) 345-2262
(970) 345-2265
Mailing address
482 ADAMS AVE, AKRON, CO 80720-1149
(970) 345-2262
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
80231
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05638457
—
CO
01
—
80231
LICENSE
CO
Enumeration date
02/21/2007
Last updated
03/07/2023
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