Individual
CHRISTOPHER J PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8990 SPRINGBROOK DR NW, COON RAPIDS, MN 55433-5850
(763) 398-0099
(763) 398-0124
Mailing address
7455 FERN CT, LORETTO, MN 55357-4713
(763) 498-7615
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
6678
NC
367500000X
Certified Registered Nurse Anesthetist
R 141490-9
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
538381100
—
MN
Enumeration date
05/01/2006
Last updated
09/10/2021
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