KRISTY L PETERSEN (NPI# 1003313115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003313115 |
| Entity Type | Individual |
| Full Name | KRISTY L PETERSEN |
| Credential | ARNP |
| Practice Address |
540 The Rialto Venice FL 34285-2900 |
| Mailing Address |
Po Box 850001 Orlando FL 32885-0001 |
| Practice Telephone | 9414866927 |
| Practice Fax Number | 9414866931 |
| Mailing Telephone | 9414866927 |
| Mailing Fax Number | 9414866931 |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2018-04-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
ARNP9335906 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | ARNP LICENSE | ARNP9335906 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407948060 | Kristy Lynn Petersen | Dentist | 10150 City Walk Dr Apt C, Woodbury, MN 55129-9270 | 2006-09-29 |
| 1225127798 | Kristy Petersen | Family Medicine | 3517 W Owen K Garriott Rd, Suite Four, Enid, OK 73703-4952 | 2006-10-12 |
| Street Address |
540 THE RIALTO |
| City | VENICE |
| State | FL |
| Zip Code | 34285-2900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639130834 | Harshit A Shah | Internal Medicine | 540 The Rialto, Venice, FL 34285-2900 | 2006-03-29 |
| 1376141986 | Emily Cunningham | Nurse Practitioner | 540 The Rialto, Venice, FL 34285-2900 | 2020-10-15 |
| 1932722188 | Venice Hma LLC | Medicare Defined Swing Bed Unit | 540 The Rialto, Venice, FL 34285-2900 | 2020-05-22 |
| 1295368629 | Bernardus Menno Hack | Physical Therapist | 540 The Rialto, Venice, FL 34285-2900 | 2020-02-13 |
| 1912538570 | Patrick Joseph Moran | Physical Therapist | 540 The Rialto, Venice, FL 34285-2900 | 2020-01-31 |
| 1891250023 | Ann Peggy Padiken | Pharmacist | 540 The Rialto, Venice, FL 34285-2900 | 2019-02-01 |
| 1073087060 | Courtney Michel Werner | Physician Assistant | 540 The Rialto, Venice, FL 34285-2900 | 2019-01-14 |
| 1255845921 | Nafisa Nathani | Nurse Practitioner | 540 The Rialto, Venice, FL 34285-2900 | 2017-11-16 |
| 1831628163 | Jeffrey Nicholas Mcdonald | Physician Assistant | 540 The Rialto, Venice, FL 34285 | 2017-06-09 |
| 1760910277 | Andrea Edwards | Internal Medicine | 540 The Rialto, Venice, FL 34285-2900 | 2017-05-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972139871 | Safe Haven Counseling LLC | Clinic/Center | 333 S. Tamiami Trail, Suite 284, Venice, FL 34285 | 2020-03-23 |
| 1518445857 | American Eagle Venice Island LLC | Alzheimer Center (Dementia Center) | 1200 Avenida Del Circo, Venice, FL 34285 | 2018-07-30 |
| 1851886915 | Jafet Baxter | Nurse Practitioner | 333 South Tamiami Trail Suite 307, Venice, FL 34285 | 2018-06-29 |
| 1023538345 | Mary Laurie | Durable Medical Equipment & Medical Supplies | 234 Tamiami Trail S, Venice, FL 34285 | 2017-06-27 |
| 1689121584 | The Sky Family Ymca Inc. | Health Educator | 701 Center Rd, Venice, FL 34285 | 2016-09-08 |
| 1033576137 | Broy Enterprises Inc. | Durable Medical Equipment & Medical Supplies | 1205 U.S. 41 Bypass South, Venice, FL 34285 | 2016-01-20 |
| 1629444013 | George C Chamberlain | Hearing Instrument Specialist | 836 Pinebrook Rd Ste D5, Venice, FL 34285 | 2015-08-19 |
| 1801287123 | Cory O'neel | Pharmacist | 1229 Us Highway 41 Byp S, Venice, FL 34285 | 2015-02-09 |
| 1831516418 | Home Detox Inc | Counselor | 530 Us 41 Bypass So, Unit 12b, Venice, FL 34285 | 2014-03-21 |
| 1922440742 | Lynn Zittel | Occupational Therapist | 841 Venetia Bay Blvd, Venice, FL 34285 | 2013-07-22 |
| Find all providers in zip 34285 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154896 | Christa Marie Mcnamara | Nurse Practitioner | 3820 Northdale Blvd Ste 107a, Tampa, FL 33624-1834 | 2020-11-03 |
| 1093315285 | Linh My Duong | Nurse Practitioner | 6184 49th Ave N, Kenneth City, FL 33709-3306 | 2020-10-28 |
| 1992304042 | Dawn Marie Decker-bowe | Nurse Practitioner | 7735 Hampton Hills Loop, New Port Richey, FL 34654-6206 | 2020-10-20 |
| 1770181182 | Lisa Maria Mercado | Nurse Practitioner | 8115 97th Ct, Vero Beach, FL 32967-2810 | 2020-10-16 |
| 1609474329 | Elisa Swieboda | Nurse Practitioner | 100 W Myrtle St, Howey In The Hills, FL 34737-4316 | 2020-10-14 |
| 1275130551 | Edgar Rafael Valdez Quinonez | Nurse Practitioner | 1212 Verdant Glade Pl, Winter Park, FL 32792-3029 | 2020-10-08 |
| 1306453683 | Madelyn Delgado Borges | Nurse Practitioner | 901 Tivoli Ter Apt 203, Deerfield Beach, FL 33441-7893 | 2020-09-30 |
| 1497362024 | Kyliene Reyes | Nurse Practitioner | 4771 Sw 138th Loop, Ocala, FL 34473-2000 | 2020-09-28 |
| 1598371882 | Curt David Miller | Nurse Practitioner | 5300 East Avenue West Palm Beach Fl, West Palm Beach, FL 33401 | 2020-09-22 |
| 1093321754 | Sangita Nair | Nurse Practitioner | 16302 Sw 23rd St, Miramar, FL 33027-4404 | 2020-09-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.