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Individual

BARBARA LOIS PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD, RN, CNS

Contact information

Practice address
2001 BLOOMINGTON AVE, MINNEAPOLIS, MN 55404-3074
(612) 301-3433
(612) 627-4205
Mailing address
2001 BLOOMINGTON AVE, MINNEAPOLIS, MN 55404-3074
(612) 301-3433
(612) 627-4205

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704231296
MI
163W00000X
Registered Nurse
R84342-9
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
4704231296
MI
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
Primary
R84342-9
MN

Other

Enumeration date
12/16/2011
Last updated
10/24/2014
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