NICOLE PETERSON (NPI# 1114540564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114540564 |
| Entity Type | Individual |
| Full Name | NICOLE PETERSON |
| Credential | PA-C |
| Practice Address |
3620 N 3rd St Phoenix AZ 85012-2020 |
| Mailing Address |
493 E Kaibab Pl Chandler AZ 85249-5309 |
| Practice Telephone | 6022817300 |
| Mailing Telephone | 5417288468 |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2020-09-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 7848 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
7848 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1760 E Florence Blvd Ste 220, Casa Grande, AZ 851224768 | 4807552210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851956072 | Nicole Peterson | Acupuncturist | 208 Oak St Ste 106e, Ashland, OR 97520-1871 | 2019-05-02 |
| 1366882938 | Nicole Yvette Peterson | Behavioral Analyst | 278 Marty Dr, Manteca, CA 95336-3450 | 2013-06-27 |
| 1225017734 | Nicole E Peterson | Physical Therapist | 1245 15th St N, Saint Cloud, MN 56303-1802 | 2006-01-12 |
| 1538780697 | Nicole Peterson | Behavior Technician | 233 S 13th St Ste 1100, Lincoln, NE 68508-2003 | 2020-04-29 |
| 1518511492 | Nicole Peterson | Registered Nurse | 1200 Collins Ave, Mandan, ND 58554-2066 | 2019-07-29 |
| 1548738743 | Nicole Peterson | Case Manager/Care Coordinator | 2600 W 9th St, Chester, PA 19013-2040 | 2018-11-06 |
| 1114411568 | Nicole Arlene Peterson | Case Manager/Care Coordinator | 682 Briergate Way, Hayward, CA 94544-7245 | 2018-06-19 |
| 1639603913 | Nicole Marie Peterson | Nurse Practitioner | 2251 N Shore Dr, Rhinelander, WI 54501 | 2017-04-13 |
| 1821547621 | Nicole Peterson | Pharmacist | 1201 W Crawford St, Salina, KS 67401-4657 | 2016-09-22 |
| 1144694068 | Nicole Sheree Peterson | Physician Assistant | 1551 Renaissance Towne Dr Ste 400, Bountiful, UT 84010-7676 | 2015-11-16 |
| Street Address |
3620 N 3RD ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85012-2020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033142666 | Cathy Kaplicki | Nurse Practitioner | 3620 N 3rd St, Phoenix, AZ 85012-2020 | 2006-07-08 |
| 1780297283 | Oscar Maciel Reyes | Nurse Practitioner | 3620 N 3rd St, Phoenix, AZ 85012-2020 | 2020-08-25 |
| 1831716083 | Amanda E. Bernal | Counselor | 3620 N 3rd St, Phoenix, AZ 85012-2020 | 2020-07-02 |
| 1548725377 | Cayla Gensler | Counselor | 3620 N 3rd St, Phoenix, AZ 85012-2020 | 2019-02-06 |
| 1457816597 | Mark Gregory Sonenschein | Nurse Practitioner | 3620 N 3rd St, Phoenix, AZ 85012 | 2019-02-03 |
| 1629532387 | Jamie Lynn Crumley | Registered Nurse | 3620 N 3rd St, Phoenix, AZ 85012-2020 | 2019-01-28 |
| 1952865610 | Jamil Marie Bayless | Registered Nurse | 3620 N 3rd St, Phoenix, AZ 85012-2020 | 2019-01-28 |
| 1063986891 | Stefan Gibson | Counselor | 3620 N 3rd St, Phoenix, AZ 85012-2020 | 2019-01-15 |
| 1356814693 | Courtney Rando | Counselor | 3620 N 3rd St, Phoenix, AZ 85012-2020 | 2019-01-09 |
| 1669942520 | Kimbralon Barnes | Counselor | 3620 N 3rd St, Phoenix, AZ 85012-2020 | 2018-12-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205417 | Diligence Physical Therapy and Wellness, Pllc | Physical Therapist | 3101 N. Central Avenue, Suite 183 # 518, Phoenix, AZ 85012 | 2020-08-17 |
| 1962023135 | Kelee Jade Forst | Student in an Organized Health Care Education/Training Program | 4001 N Third Street, Suite 290, Phoenix, AZ 85012 | 2020-04-29 |
| 1659911428 | Thomas James Blake | Social Worker | Phoenix Va Health Care System, 650 E Indian School Road, Phoenix, AZ 85012 | 2020-01-09 |
| 1598259467 | Luis F Fong | Registered Nurse | 3620 N. 3rd Street, Phoenix, AZ 85012 | 2018-06-14 |
| 1881196335 | Phoenix Surgical Solutions Pllc | Surgery | 6120 W Bell Rd Suite 130, Glendale, AZ 85012 | 2018-03-01 |
| 1679082523 | Christopher Ferguson | Physician Assistant | 1313 E. Osborn Rd., Ste 150, Phoenix, AZ 85012 | 2017-09-22 |
| 1861911323 | Viet Quoc Truong | Physician Assistant | 650 E Indian School Rd # 1, Phoenix, AZ 85012 | 2017-09-15 |
| 1720506389 | Erin Lynne Cody | Nurse Practitioner | 3003 N. 3rd St, Phoenix, AZ 85012 | 2017-09-05 |
| 1346694627 | Sharareh Najafi | Psychologist | 3450 N. 3rd Street, Phoenix, AZ 85012 | 2016-04-22 |
| 1548635824 | Rebekah June Daroff | Specialist/Technologist | 352 N Camelback Rd, Phoenix, AZ 85012 | 2015-12-11 |
| Find all providers in zip 85012 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407456585 | Chelsea Lee Townsend | Physician Assistant | 6823 S 9th Ave, Phoenix, AZ 85041-6752 | 2020-10-28 |
| 1972100949 | Amanda Alcantar | Physician Assistant | 8822 W Minnezona Ave, Phoenix, AZ 85037-1499 | 2020-10-02 |
| 1700483898 | Athena Marie Arbuckle | Physician Assistant | 3815 E Bell Rd Ste 3600, Phoenix, AZ 85032-2166 | 2020-10-02 |
| 1356957062 | Kylee Ann Lattomus | Physician Assistant | 26008 N 47th Dr, Phoenix, AZ 85083-1681 | 2020-09-17 |
| 1841801768 | Pfai Assist, Pllc | Physician Assistant | 10645 N Tatum Blvd Ste 200-556, Phoenix, AZ 85028-3068 | 2020-08-13 |
| 1285242479 | Jacob Molina | Physician Assistant | 15820 N 21st Dr, Phoenix, AZ 85023-7268 | 2020-07-14 |
| 1649898602 | Rivi Rose Sacks | Physician Assistant | 776 E Circle Rd, Phoenix, AZ 85020-4142 | 2020-07-07 |
| 1942828876 | Taylor Leblanc | Physician Assistant | 2150 W Alameda Rd Unit 1343, Phoenix, AZ 85085-1941 | 2020-07-07 |
| 1730707746 | Emily Jane Foley | Physician Assistant | 4650 N Central Ave Unit 241, Phoenix, AZ 85012-1076 | 2020-07-07 |
| 1841815230 | Alyssa Nicole Bruns | Physician Assistant | 4217 E Altadena Ave, Phoenix, AZ 85028-2232 | 2020-06-10 |
| Find all providers in PHOENIX | ||||
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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.