Katherine Renee Petersen, RPH
Individual provider Active NPI Pharmacist · Epping, NH
NPI 1023399474 · NPPES record last updated Aug 30, 2011
Key facts
- NPI
- 1023399474
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 19652 (MA)
- Practice address
- 12 Main St
Epping, NH 03042-2425 - Phone
- (603) 679-5839
- NPI assigned
- Aug 30, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19652 | MA | MD | Dentist |
| R2191 | NH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19652 | MA | Yes |
| Pharmacist | 183500000X | R2191 | NH |
Addresses
Primary practice location
12 Main St
Epping, NH 03042-2425
Mailing address
24 Morgan Dr
Epping, NH 03042-2542
Phone (603) 734-4290
Other providers in Epping, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.