Individual
SUSAN A PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3100 TONGASS AVE, KETCHIKAN, AK 99901-5746
(907) 228-8300
(907) 228-8832
Mailing address
3100 TONGASS AVE, KETCHIKAN, AK 99901-5746
(907) 228-8300
(907) 228-8832
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
7428
AK
367500000X
Certified Registered Nurse Anesthetist
Primary
36
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0168686
WA L&I
WA
01
—
6110165
AETNA
AK
Enumeration date
03/26/2007
Last updated
10/12/2007
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