ADALINE LEE PETERSON A.R.N.P. NPI 1124005236

NPI Information

NPI: 1124005236
Provider Name: ADALINE LEE PETERSON, A.R.N.P.
Classification: Nurse Practitioner - 363LX0001X
Entity Type: Individual

Specialization: Obstetrics & Gynecology

Address:
146 W DALE ST
SUITE 102
WATERLOO, IA
ZIP 50703
Phone: (319) 235-5086
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Adaline Lee Peterson, A.R.N.P. is an obstetrics and gynecology nurse practitioner in Waterloo, IA. Adaline Lee Peterson, A.R.N.P. NPI is 1124005236. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

146 W DALE ST
SUITE 102
WATERLOO, IA
ZIP 50703-901
Phone: (319) 235-5086
Fax: (319) 235-5107

The enumeration date for this NPI number is 12/29/2005 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LX0001X	Nurse Practitioner	Obstetrics & Gynecology	F-034796	IOWA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	P10289	MEDICARE UPIN	IOWA
2	55192	MEDICARE ID-TYPE UNSPECIFIED	IOWA
3	0419234	MEDICAID	IOWA
4	3419234	MEDICAID	IOWA
5	2419234	MEDICAID	IOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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