Individual
TERESA PETERSEN
Active
Individual
TERESA PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, MS, PCS
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
11-00490
KS
2251P0200X
Pediatric Physical Therapist
2004034162
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100359840B
—
KS
05
—
485072409
—
MO
Enumeration date
01/26/2007
Last updated
05/15/2013
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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