Individual
SAM RICHARD PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
201 SIVLEY RD SW STE 500, HUNTSVILLE, AL 35801-5177
(256) 265-3881
Mailing address
201 SIVLEY RD SW STE 500, HUNTSVILLE, AL 35801-5177
(256) 265-3881
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1-109909
AL
Other
Enumeration date
04/10/2012
Last updated
12/31/2025
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