Individual
KATHLEEN M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4517 N WINDINGBROOK DR, APPLETON, WI 54913-7764
(920) 858-9094
Mailing address
4517 N WINDINGBROOK DR, APPLETON, WI 54913-7764
(920) 858-9094
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
143537
WI
363L00000X
Nurse Practitioner
Primary
5090
WI
Other
Enumeration date
10/05/2012
Last updated
04/18/2022
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