Individual provider · Type 1 NPI

Ellen Tanner Peterson, RN, CPNP, MSN

Pediatric Nurse Practitioner · Oakland, CA

NPI number 1295883742 Active

Practice location

280 W Macarthur Blvd
Oakland, CA 94611-5642

Call (510) 752-6779 Map

Fax (510) 752-7836

Mailing address

15 Harte Ave
San Rafael, CA 94901-5221

Specialties and licenses

Taxonomy	Code	License
Pediatric Nurse Practitioner Primary	363LP0200X	333228 (CA)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1295883742

Ellen Tanner Peterson, RN, CPNP, MSN's National Provider Identifier is 1295883742, issued on Jan 8, 2007. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Oakland, CA. The record was last updated on Jan 3, 2022.