Christopher Petersen, R.N.
Individual provider Active NPI Emergency Registered Nurse · Moodus, CT
NPI 1396147708 · NPPES record last updated Sep 17, 2014
Key facts
- NPI
- 1396147708
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Registered Nurse 163WE0003X
- License
- 095813 (CT)
- Practice address
- 28 Leesville Rd
Moodus, CT 06469-1003 - Phone
- (860) 335-7806
- NPI assigned
- Sep 17, 2014
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 095813 | CT | MD | Emergency Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Registered Nurse | 163WE0003X | 095813 | CT | Yes |
Addresses
Primary practice location
28 Leesville Rd
Moodus, CT 06469-1003
Mailing address
28 Leesville Rd
Moodus, CT 06469-1003
Phone (860) 335-7806
Other providers in Moodus, CT
- Nathan Hale Pharmacy Inc
- Nutmeg Pharmacy Moodus LLC
- Nutmeg Pharmacy Moodus LLC
- Steven M Pear
- Peoplesdental, P.C.
- Alexandra Pires
- Lisa Beth Rogers
- Mary Alice Rossini
- Seaside Psychological
- Jessica Soucy
All providers in Moodus, CT · Emergency Registered Nurse in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2014. 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.