MS. CAROL VIRGINIA PETERSON (NPI# 1114153863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114153863 |
| Entity Type | Individual |
| Full Name | MS. CAROL VIRGINIA PETERSON |
| Credential | RN |
| Practice Address |
1700 Mall Dr Duluth MN 55811-3849 |
| Practice Telephone | 2187270990 |
| Practice Fax Number | 2184917050 |
| Mailing Telephone | 2187270990 |
| Mailing Fax Number | 2184917050 |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2009-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WA0400X |
Registered Nurse Specialization: Addiction (Substance Use Disorder) |
133133-030 | WI | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730414012 | Carol A Peterson | Health Educator | 2465 Clark Rd, Erie, PA 16510-4411 | 2009-10-05 |
| 1942466677 | Carol Ann Peterson | Social Worker | 6605 W Burnside Rd, #122, Portland, OR 97210-6625 | 2008-08-01 |
| 1538289004 | Carol Peterson | Technician | 4528 N Market St, Saint Louis, MO 63113-2113 | 2007-03-30 |
| 1518098003 | Carol Lynn Peterson | Physical Therapist | 2513 Huntingdon Chase, Atlanta, GA 30350-4964 | 2007-03-08 |
| 1295775377 | Carol M Peterson | Chiropractor | 2228 Turk Rd, Doylestown, PA 18901 | 2006-06-07 |
| 1629056080 | Carol B Peterson | Psychologist | 7400 New La Grange Rd, Ste 312, Louisville, KY 40222-4870 | 2006-01-05 |
| 1447723077 | Carol L Peterson | Speech-Language Pathologist | 700 Glasgow St, Cambridge, MD 21613-1738 | 2019-01-07 |
| 1255858510 | Carol Camille Peterson | Counselor | 505 S 12th Ave W, Virginia, MN 55792-3099 | 2017-08-28 |
| 1467744870 | Carol Jeanne Peterson | Genetic Counselor, MS | 500 Red Creek Dr, Suite 220, Rochester, NY 14623-4284 | 2011-05-04 |
| 1023309804 | Carol Jean Peterson | Nurse Practitioner | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2011-04-27 |
| Street Address |
1700 MALL DR |
| City | DULUTH |
| State | MN |
| Zip Code | 55811-3849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194962274 | Heartland PCa, LLC | Community/Behavioral Health | 1700 Mall Dr, Duluth, MN 55811-3849 | 2009-01-12 |
| 1083033377 | Cynthia Hamsmith | Registered Nurse | 1700 Mall Dr, Duluth, MN 55811-3849 | 2014-04-15 |
| 1245575984 | Mary Patricia Stevens | Registered Nurse | 1700 Mall Dr, Duluth, MN 55811-3849 | 2012-12-06 |
| 1780810333 | Cynthia Meredith Stromberg | Registered Nurse | 1700 Mall Dr, Duluth, MN 55811-3849 | 2009-06-09 |
| 1598991242 | Janet Lee Drewelow | Registered Nurse | 1700 Mall Dr, Duluth, MN 55811-3849 | 2009-06-09 |
| 1801022454 | Becky Jean Rabe | Registered Nurse | 1700 Mall Dr, Duluth, MN 55811-3849 | 2009-06-09 |
| 1083840631 | Sandra Renee Rothleutner | Registered Nurse | 1700 Mall Dr, Duluth, MN 55811-3849 | 2009-06-09 |
| 1659507309 | Kimberly Rae Bernacki | Registered Nurse | 1700 Mall Dr, Duluth, MN 55811-3849 | 2009-06-09 |
| 1437385184 | Terrica Renee Davis | Registered Nurse | 1700 Mall Dr, Duluth, MN 55811-3849 | 2009-06-09 |
| 1942436688 | Helen Dru Austin | Registered Nurse | 1700 Mall Dr, Duluth, MN 55811-3849 | 2009-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417515339 | Kyle Olson-merrick | Dentist | 320 W Myrtle St, Ste 100, Duluth, MN 55811 | 2019-06-05 |
| 1184288979 | Pdg, P.a. | Clinic/Center | 4891 Miller Truck Hwy., Suite 100, Hermantown, MN 55811 | 2019-04-26 |
| 1528589843 | Breanna Joy Greenly | Counselor | 4720 Burning Tree Road, Birch Tree Center, Duluth, MN 55811 | 2017-06-28 |
| 1396102398 | Debbie Christian | Registered Nurse | 4815 Burning Tree Rd Suite 100, Duluth, MN 55811 | 2016-01-21 |
| 1831556935 | Megan Marie Paris | Psychologist | 715 East Central Entrance, Duluth, MN 55811 | 2016-01-20 |
| 1740666908 | Angela Fedo | Physical Therapy Assistant | 2101 Trinity Rd, Duluth, MN 55811 | 2015-08-10 |
| 1649657479 | Kayla Stephenson | Specialist/Technologist | 5024 Morris Thomas Road, Hermantown, MN 55811 | 2015-04-30 |
| 1073918843 | Northern Lives Inc. | Assisted Living Facility | 4014 Trinity Road, Duluth, MN 55811 | 2014-10-23 |
| 1114326238 | Donald Hermanson | Specialist/Technologist | 801 Boulder Drive, Apt. 202, Duluth, MN 55811 | 2014-08-14 |
| 1679990857 | Jodie Little | Pharmacist | 801 W. Central Entrance, Shopko Pharmacy 2114, Duluth, MN 55811 | 2014-03-25 |
| Find all providers in zip 55811 | ||||
| Taxonomy Code | 163WA0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194231381 | Mildred Ann Cottrell | Registered Nurse | 2360 Broadway Ave N, Rochester, MN 55906-4065 | 2017-12-26 |
| 1174688873 | Gail Christine Carlson | Registered Nurse | 4536 Colfax Ave S, # 2, Minneapolis, MN 55419-4737 | 2006-12-25 |
| 1720691033 | Amy Elizabeth Simmer | Registered Nurse | 2104 Stevens Ave, Minneapolis, MN 55404-2533 | 2020-08-26 |
| 1598373730 | Mary Ann Kachelski | Registered Nurse | 602 11th Ave Nw Ste 300, Rochester, MN 55901-2297 | 2020-07-14 |
| 1821575531 | Ashley Stendahl | Registered Nurse | 680 Stewart Ave, Saint Paul, MN 55102-4117 | 2018-07-25 |
| 1982061768 | Sara Mezzano | Registered Nurse | 680 Stewart Ave, Saint Paul, MN 55102-4117 | 2016-01-25 |
| 1265829659 | Marcy Olson | Registered Nurse | 2480 S County Road 45, Owatonna, MN 55060-5113 | 2015-04-23 |
| 1609205707 | Mahilet Sisay | Registered Nurse | 1421 Park Ave Ste 104, Minneapolis, MN 55404-1579 | 2013-11-08 |
| 1598930455 | Louanne Michelle Dear-tacker | Registered Nurse | 222 9th Ave W, Alexandria, MN 56308-2221 | 2008-04-22 |
| 1437344959 | Drake Counseling Services | Registered Nurse | 28579 Us Highway 10, Detroit Lakes, MN 56501-7308 | 2007-09-07 |
| Find all providers with the same taxonomy | ||||
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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.