Individual
REBECCA D PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
1245 WASHINGTON AVE, DETROIT LAKES, MN 56501-3923
(218) 846-2000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
7249
MN
363LF0000X
Family Nurse Practitioner
Primary
7249
MN
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
7249
MN
Other
Enumeration date
02/25/2020
Last updated
04/24/2025
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