KELLY PETERSON ARNP NPI 1164087730

NPI Information

NPI: 1164087730
Provider Name: KELLY PETERSON, ARNP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
1901 S CEDAR ST STE 101
TACOMA, WA
ZIP 98405
Phone: (253) 301-5370
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Kelly Peterson, ARNP is an adult health nurse practitioner in Tacoma, WA with 5 years of experience. Kelly Peterson, ARNP NPI is 1164087730. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduation Year:2019

The provider's business location address is:

1901 S CEDAR ST STE 101
TACOMA, WA
ZIP 98405-302
Phone: (253) 301-5370

The NPI 1164087730 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/8/2019 and was last updated on 2/23/2021.

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	163W00000X	Registered Nurse		RN.382825	OHIO	No
2	363LC0200X	Nurse Practitioner	Critical Care Medicine	APRN.CNP.025246	OHIO	No
3	363LA2200X	Nurse Practitioner	Adult Health	AP61095811	WASHINGTON	Yes

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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