| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ALLISON LOUISE PETERSEN | 1982253654 | 2024-03-09 |
Allison Childs [F] graduated in 2019 and primarily specializes in Physician Assistant.
Allison Louise 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 Louise 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 Louise 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 | 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 |
| 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 |