Individual
MR. LAUREN L PETERSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
7764 FOREST CREEK CT, MAUMEE, OH 43537-9140
(419) 690-7652
(419) 697-7726
Mailing address
7764 FOREST CREEK CT, MAUMEE, OH 43537-9140
(419) 868-8329
(419) 868-8329
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
NA04744
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
RN255183
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000389988
ANTHEM
OH
01
—
000000519766
ANTHEM
OH
01
—
04097A
PHC
OH
05
—
2150569
—
OH
01
—
341881145-003
MMO
OH
05
—
5182102
—
MI
01
—
P00439234
RRMC
OH
Enumeration date
07/17/2006
Last updated
11/03/2023
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