Individual
KATHY L PETERSBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
901 MONTGOMERY ST, DECORAH, IA 52101-2325
(563) 382-2911
(563) 387-3102
Mailing address
2253 MADISON RD, DECORAH, IA 52101-7813
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0696743-1
MN
363LF0000X
Family Nurse Practitioner
Primary
J073230
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1432070
—
IA
05
—
838721400
—
MN
Enumeration date
06/13/2005
Last updated
01/22/2015
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