Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 2030 | NE |
NPI | 1992319545 |
---|---|
Provider Name | Dr. Connor Neal Peterson |
First Address | Stromsburg, NE 68666-0306 |
Second Address | Stromsburg, NE 68666-3024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2020 |
Last Update Date | 11/02/2022 |