Petersen, Jedidiah Allen

Petersen, Jedidiah Allen is an individual health care provider with primary practice located at 6 13Th Ave E , Polson MT 59860-5315. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Petersen, Jedidiah Allen can be contacted via phone (406) 883-5680.

Contact Information

Primary practice address
6 13Th Ave E Polson MT 59860-5315
Phone: (406) 883-5680
Fax: (406) 883-8960
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-1110 Idaho

Profile Details

NPI number 1366870206
LBN Legal business name Petersen, Jedidiah Allen
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 30th, 2013
Last updated Dec 8th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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