Individual
KATIE L PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Mailing address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
13465-33
WI
367500000X
Certified Registered Nurse Anesthetist
490
MN
367500000X
Certified Registered Nurse Anesthetist
R53714
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100033154
—
WI
Enumeration date
04/07/2008
Last updated
05/06/2026
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