Individual provider · Type 1 NPI

Kathryn Lynn Petersen, RN

Nurse Practitioner · Green Bay, WI

NPI number 1235616269 Active

Practice location

704 S Webster Ave Ste 501
Green Bay, WI 54301

Call (920) 433-6050 Map

Fax (920) 433-6049

Mailing address

PO Box 22487
Green Bay, WI 54305-2487

Other practice locations

744 S Webster Ave, Green Bay, WI 54301-3505 · (920) 433-3500
311 N 3rd Ave, Sturgeon Bay, WI 54235-2401 · (920) 433-6050

Specialties and licenses

Taxonomy	Code	License
Registered Nurse	163W00000X	168554-30 (WI)
Nurse Practitioner Primary	363L00000X	8598-33 (WI)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1235616269

Kathryn Lynn Petersen, RN's National Provider Identifier is 1235616269, issued on Jul 23, 2018. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Green Bay, WI. The record was last updated on Aug 14, 2018.