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Contact Information

JAMES L PETERSEN, PA-C
1025 PENNOCK PL STE 1421
FORT COLLINS, CO80524
 Phone: 970-495-8800
 Fax: 970-495-8820
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for JAMES L PETERSEN · (Male)

NPI # 1467672774
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 04/27/2007
Last updated 11/21/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • CO License # 1491
  • CO Medicaid 75979837
  • WY Medicaid 126606300
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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