Individual
MRS. COLLEEN ANN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
14990 91ST AVE N, MAPLE GROVE, MN 55369-8831
(763) 420-5759
Mailing address
14990 91ST AVE N, MAPLE GROVE, MN 55369-8831
(763) 420-5759
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R98713-6
MN
Other
Enumeration date
02/21/2011
Last updated
02/21/2011
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