Most Relevant Information
Provider Data
| NPI Number: | 1003809062 |
| Provider Name: | BARBARA LYNN PETERSON PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | 8983 |
Most Important Dates
| Enumeration Date: | 08/25/2005 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1619 DAYTON AVE
STE 205
SAINT PAUL
MN
551046206
Practice Location Phone/Fax
| Phone: | 6516450478 |
| Fax: | 6516422523 |
Provider Mailing Location
1515 FAIRMOUNT AVE
SAINT PAUL
MN
551052315
Provider Mailing Phone/Fax
| Phone: | 6516993115 |
| Fax: |