| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ALLISON L PETERSEN | 1982253654 | 2019-09-05 |
Allison Childs [F] graduated in 2019 and primarily specializes in Physician Assistant.
Allison L Petersen is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1982253654. Registration indicates Allison L Petersen is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers) Access to Adult/Geriatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| PECOS ID | 3173955747 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Ms. Allison L Petersen PA-C |
| Other Provider Name | Allison Childs |
| Practice Office Address | 2402 WINNEBAGO ST MADISON, WI US |
| Practice Office Telephone | 6088287603 |
| Mailing Address | 7974 UW HEALTH CT MIDDLETON, WI 535625531 US |
| Address | City / State | Phone / Fax |
|---|---|---|
| 12221 Renfert Way Ste 110 | Austin, TX 787585658 | 5126010303 / 5126010333 |
| Code | Practice | License No State |
|---|---|---|
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | 7670-23
WI |
| 363A00000X | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | PA12971
TX |