Individual
KATHLEEN S PETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3931 LOUISIANA AVE S, STE E400, ST LOUIS PARK, MN 55426-4375
(952) 993-3230
Mailing address
3800 PARK NICOLLET BLVD, CREDENTIALING, ST LOUIS PARK, MN 55416-2527
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
34659
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
589078100
—
MN
Enumeration date
11/30/2005
Last updated
03/06/2012
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