Individual
KRISTINA PETTERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 COLLINS AVE, MANDAN, ND 58554-2067
(701) 663-5373
Mailing address
1200 COLLINS AVE, MANDAN, ND 58554-2067
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L13676
ND
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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