Individual
RON PETERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1100 CARSON AVE, SUITE 201, LA JUNTA, CO 81050-2751
(719) 383-5900
(719) 383-6533
Mailing address
1100 CARSON AVE, SUITE 201, LA JUNTA, CO 81050-2751
(719) 383-5900
(719) 383-6533
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
55424
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
840706945002
ROCKY MOUNTAIN HEALTH PLA
CO
Enumeration date
10/24/2005
Last updated
07/08/2007
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