PETERSON MEDICAL LLC
NPI 1033762513
Nurse Practitioner - Family in Blanchard, OK
Active since July 23, 2019
About Peterson Medical Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PETERSON MEDICAL LLC (NPI 1033762513) is a healthcare organization registered as a family in Blanchard, Oklahoma and active in the NPI registry since July 2019. The organization lists Braden Peterson, Member, as its authorized official.
NPPES Registry Identity
NPI1033762513
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NamePETERSON MEDICAL LLC
Location Address217 N HARRISON AVEBlanchard, OK 73010-6211
Mailing Address701 Ne 36th StOklahoma City, OK 73105-7203 · (405) 631-0611
Phone(405) 631-0611
Organization SubpartNo
Authorized OfficialBraden PetersonMember · (580) 235-1657
Enumeration DateJuly 23, 2019
✔ NPI 1033762513 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
217 N HARRISON AVE, Blanchard, OK 73010
Group Practice 1
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1033762513, enumerated as an "organization" on July 23, 2019.
The provider is located at 217 N HARRISON AVE BLANCHARD, OK 73010 and the phone number is (405) 631-0611.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
