Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MEKENNA PETERSON, ATC, SA
Active Sole ProprietorMEKENNA PETERSON, ATC, SA is a Athletic Trainer healthcare provider located in BOULDER, Colorado. NPI 1780126680 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · BOULDER, CO
Registration Details
- NPI Number
- 1780126680
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 8, 2016 (9.7318276938904 yrs)
- Last Updated
- Sep 1, 2021
- Licenses
-
20-0208 (CO)AT.0001978 (CO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2150 STADIUM DRIVE FLOOR 2BOULDER, CO, 803099117Browse CO providers · Browse ZIP 80309
- Phone
- 3033159900
- Primary Specialty
-
Athletic Trainer
2255A2300X
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- Athletic Trainer
Other Athletic Trainer Providers in BOULDER, CO
| Name | Credential | NPI |
|---|---|---|
| KIMBERLY R DETWILER | MS, LAT, ATC, CSCS | 1265496194 |
| JACLYN MARIE ADAMS | ATC | 1386602928 |
| MS. REBECCA JEAN TOBER | REBECCA TOBER, ATC | 1558387910 |
| MARCI ROSCHKE | ATC | 1104844018 |
| LEILA A ALMAHDY | ATC | 1285778415 |
| DENISE KNUTSON | — | 1457753683 |
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.