Petersen, Lisa R
Petersen, Lisa R is an individual health care provider with primary practice located at 280 Exempla Cir , Lafayette CO 80026-3370. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Petersen, Lisa R can be contacted via phone (303) 338-4545.Contact Information
Primary practice address
280 Exempla Cir
Lafayette CO 80026-3370
Phone: (303) 338-4545
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2798 | Colorado |
Profile Details
| NPI number | 1982917209 |
|---|---|
| LBN Legal business name | Petersen, Lisa R |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 15th, 2010 |
| Last updated | Jun 23rd, 2021 - about 5 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 | 1982917209 | NPPES |
| Colorado | Other | 022563 | KAISER COMMERCIAL NUMBER |
| Colorado | MEDICAID | 21351058 | KAISER COMMERCIAL NUMBER |
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