IndividualActive
Jim Pederson, PA
NPI 1902829773 · Medical Physician Assistant · Rawlins, WY
Provider details
- NPI number
- 1902829773
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- License
- 083 (WY)
Mailing address
606 23rd St
Rawlins, WY 82301-5127
Registry dates
- Enumerated
- 2006-07-25
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.