Individual
MCKENZIE REILE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, APRN, FNP-C
Contact information
Practice address
705 E MAIN AVE, BISMARCK, ND 58501-4525
(701) 502-4669
(833) 608-1015
Mailing address
PO BOX 7433, BISMARCK, ND 58507-7433
(701) 226-7586
(833) 608-1015
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R36156
ND
Other
Enumeration date
05/31/2017
Last updated
11/12/2021
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