Individual
NEAL MICHAEL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1506 S ONEIDA ST, APPLETON, WI 54915-1396
(920) 738-2000
Mailing address
3327 N CASALOMA DR UNIT 172, APPLETON, WI 54913-7968
(715) 340-6399
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
226904-30
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
138682
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/06/2022
Last updated
05/27/2022
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