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Individual

HOANG KIM PETERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITIONER

Contact information

Practice address
16728 E SMOKY HILL RD UNIT 10D, CENTENNIAL, CO 80015-2400
(303) 766-7006
(303) 766-1023
Mailing address
2550 N THUNDERBIRD CIR STE 303, MESA, AZ 85215-1219
(480) 455-4932
(480) 776-0025

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-10342
CO
363LP0200X
Pediatric Nurse Practitioner
1649
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200342180 A
OK
05
283185101
TX
05
283185102
TX
05
283185103
TX
05
283185104
TX
05
78459834
NM
Enumeration date
01/26/2011
Last updated
03/17/2018
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