MRS. CARISSA PETERSON ARNP NPI 1376097105

NPI Information

NPI: 1376097105
Provider Name: MRS. CARISSA PETERSON, ARNP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Organization: ADVANCED HEALTHCARE INTEGRATION LLC

PECOS Registration: Yes

Address:
602 W INDIAN RIVER BLVD
STE 2&3
EDGEWATER, FL
ZIP 32132
Phone: (386) 663-3003
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MRS. Carissa Peterson, ARNP is an adult health nurse practitioner in Edgewater, FL with 8 years of experience. MRS. Carissa Peterson, ARNP NPI is 1376097105. 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:

602 W INDIAN RIVER BLVD
STE 2&3
EDGEWATER, FL
ZIP 32132-591
Phone: (386) 663-3003

The NPI 1376097105 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 8/10/2016 and was last updated on 6/10/2019.

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	363LA2200X	Nurse Practitioner	Adult Health	ARNP9249998	FLORIDA	Yes
2	363LG0600X	Nurse Practitioner	Gerontology	ARNP9249998	FLORIDA	No

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: 11/14/2023

NPI Synchronization or Removal

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