Individual
ALLISON WICHMANN PETERSEN
Active
Individual
ALLISON WICHMANN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
11606
MN
363A00000X
Physician Assistant
11606
MN
363AS0400X
Surgical Physician Assistant
11606
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1633878
BCBS PPO
IL
01
—
P01010061
RR MEDICARE
IL
Enumeration date
06/18/2009
Last updated
04/23/2026
Update your record
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