Petersen, Kristina
Petersen, Kristina is an individual health care provider with primary practice located at 2580 Hway 95 # 1250 , Bullhead City AZ 86442-7491. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Petersen, Kristina can be contacted via phone (928) 763-7776.Contact Information
Primary practice address
2580 Hway 95 # 1250
Bullhead City AZ 86442-7491
Phone: (928) 763-7776
Fax: (928) 763-7786
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 13439 | Arizona |
Profile Details
| NPI number | 1104229806 |
|---|---|
| LBN Legal business name | Petersen, Kristina |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 8th, 2014 |
| Last updated | Oct 8th, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104229806 | NPPES |
| Arizona | MEDICAID | PENDING |
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