PAMELA B PETERSON (NPI# 1073656682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073656682 |
| Entity Type | Individual |
| Full Name | PAMELA B PETERSON |
| Credential | NP |
| Practice Address |
2360 Mullan Rd Ste C Missoula MT 59808-1811 |
| Practice Telephone | 4067214436 |
| Practice Fax Number | 4065421037 |
| Mailing Telephone | 4067214436 |
| Mailing Fax Number | 4065421037 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2014-08-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN18519 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | BLUE CROSS BLUE SHIELD | 000372730 | 01 |
| MT | 0439998 | 05 | |
| RAILROAD MEDICARE | 500027942 CK5082 | 01 | |
| ID | 806516800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235659996 | Pamela Sue Peterson | Counselor | 110 Reading Ave, Jonesville, MI 49250-1136 | 2017-06-23 |
| 1700330503 | Pamela Peterson | Counselor | 332 W Superior St Ste 300, Duluth, MN 55802 | 2016-08-09 |
| 1871834614 | Pamela Peterson | Social Worker | 118 N 5th St, Oneill, NE 68763-1565 | 2013-03-04 |
| 1417204579 | Pamela Nichole Peterson | Behavioral Analyst | 33 Turnpike Rd, Southborough, MA 01772-2108 | 2012-08-08 |
| 1609186709 | Pamela Diane Peterson | Massage Therapist | 1155 Ne Hogan Dr, Gresham, OR 97030-4129 | 2010-10-07 |
| 1871821777 | Pamela Eileen Peterson | Counselor | 287 6th St E, Suite 300, Saint Paul, MN 55101-1654 | 2009-12-03 |
| 1972674091 | Pamela Marjorie Peterson | Psychologist | 300 W Broadway, Ste 1, Plainview, MN 55964-1256 | 2006-11-11 |
| 1124121256 | Pamela C Peterson | Social Worker | 48 N Pleasant St, Suite 302, Amherst, MA 01002-1738 | 2006-09-06 |
| 1396851853 | Pamela N Peterson | Internal Medicine | 777 Bannock St, Mc 7782, Denver, CO 80204-4507 | 2006-08-21 |
| 1972516532 | Pamela Peterson | Registered Nurse | 945 Goethals Dr, Suite 200, Richland, WA 99352-3552 | 2006-08-14 |
| Street Address |
2360 MULLAN RD STE C |
| City | MISSOULA |
| State | MT |
| Zip Code | 59808-1811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548255540 | Jeffrey Mariano Laporte | Orthopaedic Surgery | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2005-09-15 |
| 1245855030 | Cayden Napierala | Physical Therapist | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2020-06-08 |
| 1629617956 | Kathryn Diane Fisette | Physical Therapist | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2020-01-03 |
| 1245889484 | Mitchell Mayfield | Physician Assistant | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2019-09-10 |
| 1750876041 | Samantha Rose Gunderson Morton | Physical Therapist | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2018-06-28 |
| 1790207090 | Taylor Danielle Manning | Specialist/Technologist | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2017-07-09 |
| 1871048801 | Jessica Paske | Specialist/Technologist | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2016-08-19 |
| 1013365386 | Matthew Schumacher | Physical Therapist | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2016-05-27 |
| 1710361175 | Lindsey Marie Ross | Specialist/Technologist | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2015-07-16 |
| 1144669912 | James Joseph Gholson | Orthopaedic Surgery | 2360 Mullan Rd Ste C, Missoula, MT 59808 | 2013-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447720875 | Megan Elizabeth Galliford | Behavioral Analyst | 1647 Shindig Dr, Apt 303, Missoula, MT 59808 | 2018-11-28 |
| 1518473560 | Willow Mahana Nelson Griffith | Registered Nurse | 2829 Great Northern Loop Ste 300, Missoula, MT 59808 | 2017-12-28 |
| 1043739428 | Carol Elizabeth Mckenzie | Student in an Organized Health Care Education/Training Program | 2705 Oshaughnessy St, Missoula, MT 59808 | 2017-09-16 |
| 1558884064 | Sharon Marie Herndon | Nurse Practitioner | 2230 N Reserve St Ste 402, Missoula, MT 59808 | 2017-07-18 |
| 1427594761 | Erin Boggs | Specialist/Technologist | 2921 Dublin St, Missoula, MT 59808 | 2017-01-10 |
| 1942603287 | Benjamin Cody Mcintosh | Chiropractor | 1070 N. Russell St., Missoula, MT 59808 | 2014-10-01 |
| 1518219617 | Pure Medical Inc | Ambulance | 5515 Bonanza Place, Missoula, MT 59808 | 2012-10-12 |
| 1932462231 | Kathleen F Calcagno | Specialist/Technologist | 2615 Connery Way, Suite 2b, Missoula, MT 59808 | 2012-06-21 |
| 1639454127 | Dentyn Dunaway | Pharmacist | 2527 N Reserve Street, Missoula, MT 59808 | 2011-10-15 |
| 1750557690 | Carl Thornblade, Md, Pllc | Allergy & Immunology | 2801 Great Northern Loop Ste 101, Missoula, MT 59808 | 2008-04-30 |
| Find all providers in zip 59808 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730656299 | Brandi Roman Glibbery | Nurse Practitioner | 4109 Barbara Ln, Missoula, MT 59803-1114 | 2018-11-01 |
| 1326526948 | Ruth Elizabeth King | Nurse Practitioner | 6114 Helena Dr, Missoula, MT 59803-2706 | 2018-08-06 |
| 1205313590 | Michelle Weaver Knowles | Nurse Practitioner | 2825 Fort Missoula Rd Ste 113, Missoula, MT 59804-7403 | 2018-07-19 |
| 1467995928 | Sarah Slater | Nurse Practitioner | 1101 S 3rd St W Ste 101, Missoula, MT 59801-2321 | 2016-11-30 |
| 1992161772 | Jennifer Jane Lee Simon | Nurse Practitioner | 500 W Broadway St Ste 310, Missoula, MT 59802-4003 | 2016-01-08 |
| 1427489822 | Katrina Lin Brucker | Nurse Practitioner | 902 N Orange St Ste 202, Missoula, MT 59802-2928 | 2013-12-10 |
| 1659704526 | Heidi Efinger | Nurse Practitioner | 2340 Mullan Rd, Missoula, MT 59808-1830 | 2013-08-15 |
| 1427301589 | Adeline May Wakeman | Nurse Practitioner | 728 Monroe St, Apt. A, Missoula, MT 59802-3716 | 2012-10-25 |
| 1871843953 | Autum Emerson Howell | Nurse Practitioner | 2831 Ft. Missoula Rd. Bldg 2, 102, Missoula, MT 59804 | 2012-09-14 |
| 1780946764 | Ka Moua | Nurse Practitioner | 2685 Palmer St Ste D, Missoula, MT 59808-1709 | 2012-06-14 |
| Find all providers in MISSOULA | ||||
Please comment or provide details below to improve the information on PAMELA B PETERSON.
| 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.