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Contact Information

LISA M PETERSON, PA-C
1500 14TH ST W STE 300
WILLISTON, ND58801-4079
 Phone: 701-774-7500
 Fax: 701-774-3918
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for LISA M PETERSON · (Female)

NPI Number 1619156411
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 10/29/2007
Last updated 07/21/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • ND License # PAC0377
Hospital affiliation(s)
  • MERCY MEDICAL CENTER - (Critical Access)
    1301 15TH AVE W
    WILLISTON, ND 58801
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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