Individual
NORMA J PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
65 N MEDICAL DR, JOHN MORAN EYE CENTER UNIVERSITY OF UTAH, SALT LAKE CITY, UT 84132-1000
(801) 587-6635
Mailing address
65 N MEDICAL DR, JOHN MORAN EYE CENTER UNIVERSITY OF UTAH, SALT LAKE CITY, UT 84132-1000
(801) 587-6635
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
098006028 CRNA
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210223
—
OR
Enumeration date
10/03/2005
Last updated
09/24/2007
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