JERIANN C PETER FNP NPI 1639405434

NPI Information

  • NPI: 1639405434
  • Provider Name: JERIANN C PETER, FNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 7555 ENCHANTED HILLS BLVD NE STE 104
    RIO RANCHO, NM
    ZIP 87144
  • Phone: (505) 771-9833

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NPI Details

Jeriann C Peter, FNP is a family nurse practitioner in Rio Rancho, NM with 18 years of experience. Jeriann C Peter, FNP NPI is 1639405434. 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:

7555 ENCHANTED HILLS BLVD NE STE 104
RIO RANCHO, NM
ZIP 87144-625
Phone: (505) 771-9833

The NPI 1639405434 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 10/29/2009 and was last updated on 9/18/2023.

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
1163W00000XRegistered Nurse2005021426MISSOURINo
2163W00000XRegistered Nurse53068NEW MEXICONo
3363LF0000XNurse PractitionerFamily2005021426MISSOURINo
4363LP2300XNurse PractitionerPrimary Care2005021426MISSOURINo
5363LF0000XNurse PractitionerFamily53068NEW MEXICOYes

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
11639405434MEDICAIDMISSOURI
21639405434MEDICAIDILLINOIS

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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