Individual
MS. KRISTIN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3205 N ACADEMY BLVD, SUITE 100, COLORADO SPRINGS, CO 80917-5101
(719) 632-5700
Mailing address
3205 N ACADEMY BLVD, SUITE 130, COLORADO SPRINGS, CO 80917-5101
(719) 632-5700
(719) 344-7837
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1148
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55431763
—
CO
Enumeration date
02/07/2006
Last updated
04/04/2017
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