AMANDA JANE PETERSON NPI 1528503695

NPI Information

NPI: 1528503695
Provider Name: AMANDA JANE PETERSON
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
1351 W CENTRAL PARK AVE
DAVENPORT, IA
ZIP 52804
Phone: (563) 421-1900
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Amanda Jane Peterson is a family nurse practitioner in Davenport, IA with 8 years of experience. Amanda Jane Peterson NPI is 1528503695. 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:

1351 W CENTRAL PARK AVE
DAVENPORT, IA
ZIP 52804-853
Phone: (563) 421-1900
Fax: (563) 421-1809

The NPI 1528503695 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 12/28/2016 and was last updated on 9/28/2023.

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		132137	IOWA	No
2	163W00000X	Registered Nurse		041511033	ILLINOIS	No
3	363LF0000X	Nurse Practitioner	Family	209023700	ILLINOIS	No
4	363LF0000X	Nurse Practitioner	Family	A165003	IOWA	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: 5/5/2024

NPI Synchronization or Removal

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