Individual
KELLEY ANN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
6000 UNIVERSITY AVE, SUITE 310, WEST DES MOINES, IA 50266-8203
(515) 277-8900
(515) 223-7361
Mailing address
13682 LAKE SHORE DR, CLIVE, IA 50325-8640
(515) 277-8900
(515) 223-7361
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
01571
IA
Other
Enumeration date
08/15/2005
Last updated
07/08/2007
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