Individual
TIFFANY LEE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2116 CRAIG RD, EAU CLAIRE, WI 54701-6118
(715) 858-4500
Mailing address
2116 CRAIG RD, EAU CLAIRE, WI 54701-6118
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
11741
WI
367500000X
Certified Registered Nurse Anesthetist
137670
WI
Other
Enumeration date
08/27/2021
Last updated
12/02/2025
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