Individual
KELLY PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6205 DOMINION DR, MADISON, WI 53718-3124
(262) 719-7224
Mailing address
608 E MAIN ST, MOUNT HOREB, WI 53572-2039
(608) 293-2746
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
178542
WI
Other
Enumeration date
01/03/2016
Last updated
01/03/2016
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