Individual provider · Type 1 NPI

Jacob Peterson

Student in an Organized Health Care Education/Training Program · Madison, WI

NPI number 1699597963 Active

Practice location

1475 Engineering Dr
Madison, WI 53706-1607

Call (608) 264-8065 Map

Mailing address

1815 University Ave Apt 200
Madison, WI 53726-4092

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1699597963

Jacob Peterson's National Provider Identifier is 1699597963, issued on Oct 29, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Madison, WI. The record was last updated on Oct 29, 2024.