Most Relevant Information
Provider Data
| NPI Number: | 1003528514 |
| Provider Name: | MANDEE PETERSON CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 147010 |
Most Important Dates
| Enumeration Date: | 12/15/2022 |
| Last Updated: | 01/23/2023 |
Provider Practice Location
300 PINELLAS ST
CLEARWATER
FL
337563804
Practice Location Phone/Fax
| Phone: | 7274627000 |
| Fax: |
Provider Mailing Location
1701 CENTRAL AVE UNIT 575
ST PETERSBURG
FL
337138992
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |