KATIE LYNNE PETERSON PA-C NPI 1528119906

NPI Information

NPI: 1528119906
Provider Name: KATIE LYNNE PETERSON, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
3151 N WINDSONG DR
PRESCOTT VALLEY, AZ
ZIP 86314
Phone: (928) 778-4711
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Katie Lynne Peterson, PA-C is a medical physician assistant in Prescott Valley, AZ. Katie Lynne Peterson, PA-C NPI is 1528119906. 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:

3151 N WINDSONG DR
PRESCOTT VALLEY, AZ
ZIP 86314-240
Phone: (928) 778-4711

The enumeration date for this NPI number is 1/14/2007 and was last updated on 5/10/2017.

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	2255A2300X	Specialist/Technologist	Athletic Trainer	36001348A	INDIANA	No
2	363AM0700X	Physician Assistant	Medical	PA21714	CALIFORNIA	No
3	363AM0700X	Physician Assistant	Medical	6032	ARIZONA	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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