JUDY L PETERSON (NPI# 1033177985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033177985 |
| Entity Type | Individual |
| Full Name | JUDY L PETERSON |
| Credential | CNNP CPNP |
| Practice Address |
347 North Smith Ave Childrens Specialty Clinic Nicu St Paul MN 55102 |
| Mailing Address |
2910 Centre Pointe Dr 35-121a Childrens Health Care Roseville MN 55113 |
| Practice Telephone | 6512206210 |
| Practice Fax Number | 6512207777 |
| Mailing Telephone | 6518552327 |
| Mailing Fax Number | 6518552310 |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
R1013148 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| X | 363LN0005X |
Nurse Practitioner Specialization: Neonatal, Critical Care |
R1013148 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| X | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
R1013148 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285006684 | Judy Patricia Peterson | Occupational Therapy Assistant | 2425 Nieto Way, Medford, OR 97504-8577 | 2015-10-24 |
| 1386704476 | Judy A Peterson | Pharmacist | 2200 Bergquist Dr, Suite 1, Lackland Afb, TX 78236-9908 | 2006-12-11 |
| 1750376216 | Judy Garrett Peterson | Pharmacist | 1000 Johnson Ferry Rd Ne, Northside Hospital Pharmacy, Atlanta, GA 30342-1606 | 2005-09-12 |
| Street Address |
347 NORTH SMITH AVE CHILDRENS SPECIALTY CLINIC NICU |
| City | ST PAUL |
| State | MN |
| Zip Code | 55102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417923533 | Laura G Hoyt | Pediatrics | 347 North Smith Ave, Childrens Specialty Clinic Infectious Diseases Stpl, St Paul, MN 55102 | 2006-02-28 |
| 1114983749 | Shelly A Hansen | Nurse Practitioner | 347 North Smith Ave, Childrens Specialty Clinic Nicu, St Paul, MN 55102 | 2006-04-22 |
| 1447215462 | Marlene D Wuethrich | Nurse Practitioner | 347 North Smith Ave, Childrens Specialty Clinic Nicu, St Paul, MN 55102 | 2006-04-20 |
| 1962463547 | Mark J Hudson | Pediatrics | 347 North Smith Ave, 401, St Paul, MN 55102 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720623366 | Ning Wu | Acupuncturist | Tcm Health Center, 613 Grand Ave., St. Paul, MN 55102 | 2019-11-07 |
| 1730730615 | Tianwei Guo | Acupuncturist | 613 Grand Avenue, Saint Paul, MN 55102 | 2019-09-23 |
| 1194374850 | Justin Crawford Diehl | Counselor | 976 Juno Avenue, Saint Paul, MN 55102 | 2019-09-05 |
| 1699329169 | Elisabeth Johanna Wurtmann | Genetic Counselor, MS | 310 N Smith Avenue Suite 300, Saint Paul, MN 55102 | 2019-08-01 |
| 1265907083 | Lillia Budd | Nurse Practitioner | 225 Smith Ave N - Suite 400, Mail Route 65400, Saint Paul, MN 55102 | 2018-10-08 |
| 1922505098 | Women of Nations | Substance Abuse Rehabilitation Facility | 73 Leech Street, St. Paul, MN 55102 | 2018-04-06 |
| 1609371939 | Courtney Marie Klinkhammer | Student in an Organized Health Care Education/Training Program | 1026 West Seventh Street, St. Paul, MN 55102 | 2018-03-28 |
| 1427429372 | Compass Pathology and Consulting | Clinical Medical Laboratory | 360 Sherman St Suite 400b, St. Paul, MN 55102 | 2015-10-16 |
| 1639550494 | Daniel Delapp | Speech-Language Pathologist | United Hospital 333 Smith Avenue N, Mail Route 60104, St. Paul, MN 55102 | 2015-06-17 |
| 1124419940 | Suzanne Carl | Speech-Language Pathologist | 360 Colborne Avenue, St. Paul, MN 55102 | 2015-02-16 |
| Find all providers in zip 55102 | ||||
| Taxonomy Code | 363LN0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Neonatal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740369602 | Diane J Schmidt | Nurse Practitioner | 347 North Smith Avenue, Childrens Specialty Clinic Nicu, St Paul, MN 55102 | 2006-11-03 |
| 1205892833 | Carmen Renee Grande Henke | Nurse Practitioner | 347 North Smith Avenue, Childrens Specialty Clinic Nicu, St Paul, MN 55102 | 2006-04-22 |
| 1114983749 | Shelly A Hansen | Nurse Practitioner | 347 North Smith Ave, Childrens Specialty Clinic Nicu, St Paul, MN 55102 | 2006-04-22 |
| 1023074655 | Gretchen L Hanson | Nurse Practitioner | 347 North Smith Avenue, Childrens Specialty Clinic - Nicu, St Paul, MN 55102 | 2006-04-22 |
| 1699730564 | Linda C Brakke | Nurse Practitioner | 347 North Smith Avenue, Childrens Specialty Clinic - Nicu, St Paul, MN 55102 | 2006-04-20 |
| 1801851845 | Ann V Myron Smith | Nurse Practitioner | 347 North Smith Avenue, Childrens Specialty Clinic - Nicu, St Paul, MN 55102 | 2006-04-20 |
| 1447215462 | Marlene D Wuethrich | Nurse Practitioner | 347 North Smith Ave, Childrens Specialty Clinic Nicu, St Paul, MN 55102 | 2006-04-20 |
| 1134184054 | Deborah L Lalonde | Nurse Practitioner | 347 North Smith Avenue, Childrens Specialty Clinic - Nicu, St Paul, MN 55102 | 2006-04-20 |
| 1659337582 | Audrey E Kinzer Coleman | Nurse Practitioner | 347 North Smith Avenue, Childrens Specialty Clinic - Nicu, St Paul, MN 55102 | 2006-04-20 |
| 1841255213 | Lorraine C Victor | Nurse Practitioner | 347 North Smith Avenue, Childrens Speciality Clinic Nicu, St Paul, MN 55102 | 2006-04-19 |
| Find all providers in ST PAUL | ||||
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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.