Individual
JULIETTE E PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6525 DREW AVE S, EDINA, MN 55435
(952) 920-6748
(952) 920-3863
Mailing address
6525 DREW AVE S, EDINA, MN 55435
(952) 920-6748
(952) 920-3863
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
46488
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136399
UCARE
MN
01
—
338G8PE
BCBS
MN
Enumeration date
08/21/2006
Last updated
07/08/2007
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