MRS. PENNY LU PETERSON RN NPI 1659576833

NPI Information

NPI: 1659576833
Provider Name: MRS. PENNY LU PETERSON, RN
Classification: Registered Nurse - 163WP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
3730 STATE ROUTE 21
WAYLAND, NY
ZIP 14572
Phone: (585) 534-5170
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MRS. Penny Lu Peterson, RN is a pediatrics registered nurse in Wayland, NY. MRS. Penny Lu Peterson, RN NPI is 1659576833. 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:

3730 STATE ROUTE 21
WAYLAND, NY
ZIP 14572-727
Phone: (585) 534-5170

The enumeration date for this NPI number is 6/18/2007 and was last updated on 7/9/2007.

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	163WP0200X	Registered Nurse	Pediatrics	273148-1	NEW YORK	Yes

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
1	02682171	MEDICAID	NEW YORK

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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