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Individual

ALYSSA LAUREN PETERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-0509
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3310
(414) 805-3885

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8271
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1811791965
WI
Enumeration date
04/01/2025
Last updated
10/14/2025
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