Individual
KERI PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1821 SOUTH AVE W STE 402, MISSOULA, MT 59801-6518
(406) 543-8512
(406) 541-8513
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MED-PAC-LIC-160046
MT
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/23/2023
Last updated
04/22/2026
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