KIMBERLEY MICHELLE PETERSEN NP NPI 1508000878

NPI Information

  • NPI: 1508000878
  • Provider Name: KIMBERLEY MICHELLE PETERSEN, NP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • Address: 634 EDDY AVE
    MISSOULA, MT
    ZIP 59812
  • Phone: (406) 243-2122

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NPI Details

Kimberley Michelle Petersen, NP is a psychiatric/mental health nurse practitioner in Missoula, MT. Kimberley Michelle Petersen, NP NPI is 1508000878. 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:

634 EDDY AVE
MISSOULA, MT
ZIP 59812-601
Phone: (406) 243-2122

The enumeration date for this NPI number is 4/29/2009 and was last updated on 7/21/2022.

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
1363LP0808XNurse PractitionerPsychiatric/Mental Health100360MONTANAYes

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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