Individual
MRS. CYNTHIA W PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1801 HICKMAN RD, DES MOINES, IA 50314-1505
(515) 282-2200
Mailing address
1801 HICKMAN RD, DES MOINES, IA 50314-1505
(515) 282-2200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A094853
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437244
—
IA
01
—
36418
WELLMARK BLUE SHIELD
IA
Enumeration date
02/08/2006
Last updated
03/05/2021
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