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Individual

WENDY PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1730 HAINES AVE, RAPID CITY, SD 57701-0615
(605) 721-4934
(605) 791-7704
Mailing address
PO BOX 817, RAPID CITY, SD 57709-0817
(605) 721-4934
(605) 791-7704

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1004
SD
363A00000X
Physician Assistant
2991
OK
363A00000X
Physician Assistant
3581
GA

Other

Enumeration date
11/04/2005
Last updated
01/21/2019
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