Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. ELIZA S. PETERSEN, AUD, CCCA
Active Sole ProprietorDR. ELIZA S. PETERSEN, AUD, CCCA is a Audiologist healthcare provider located in DRIGGS, Idaho. NPI 1083750996 is currently active in the NPPES registry. Verify at CMS.
Audiologist · DRIGGS, ID
Registration Details
- NPI Number
- 1083750996
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 29, 2007 (19.578090263558 yrs)
- Last Updated
- Apr 19, 2023
- Licenses
-
A-974 (WY)AUD-1142 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2740 SHADOWMOON LN STE 417DRIGGS, ID, 834225083Browse ID providers · Browse ZIP 83422
- Phone
- 3077455587
- Fax
- 8775151633
- Primary Specialty
-
Audiologist
231H00000X
- Additional Specialty
- Audiologist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.