Individual
ERIC L PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN FNP-BC
Contact information
Practice address
4100 DEWEY ST, MANITOWOC, WI 54220-5497
(920) 686-5700
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5433-33
WI
363LF0000X
Family Nurse Practitioner
5433-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100034550
—
WI
Enumeration date
10/02/2013
Last updated
12/03/2025
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