CAROL JEAN PETERSON APNP NPI 1023309804

NPI Information

  • NPI: 1023309804
  • Provider Name: CAROL JEAN PETERSON, APNP
  • Classification: Nurse Practitioner - 363L00000X
  • Entity Type: Individual
  • Address: 744 S WEBSTER AVE
    GREEN BAY, WI
    ZIP 54301
  • Phone: (920) 445-7222

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NPI Details

Carol Jean Peterson, APNP is a nurse practitioner in Green Bay, WI. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. Carol Jean Peterson, APNP NPI is 1023309804. 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:

744 S WEBSTER AVE
GREEN BAY, WI
ZIP 54301-505
Phone: (920) 445-7222
Fax: (920) 445-7238

The enumeration date for this NPI number is 4/27/2011 and was last updated on 6/5/2015.

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
1363L00000XNurse Practitioner4378-033WISCONSINYes

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 Other Provider Identifier Issuer
1007170064MEDICARE OSCAR/CERTIFICATIONWISCONSIN
2075100136MEDICARE OSCAR/CERTIFICATIONWISCONSIN
3078450064MEDICARE OSCAR/CERTIFICATIONWISCONSIN
407028MEDICARE PINWISCONSIN
5430751201MEDICARE OSCAR/CERTIFICATIONWISCONSIN
6590050059MEDICARE OSCAR/CERTIFICATIONWISCONSIN
7WI1119014MEDICARE OSCAR/CERTIFICATIONWISCONSIN
88002100039MEDICARE OSCAR/CERTIFICATIONWISCONSIN
971700064MEDICARE OSCAR/CERTIFICATIONWISCONSIN

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: 11/21/2025

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