ANDRIA JO PETERSEN (NPI# 1194280156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194280156 |
| Entity Type | Individual |
| Full Name | ANDRIA JO PETERSEN |
| Other Name | ANDRIA JO HOMAN |
| Credential | NP-C |
| Practice Address |
2400 W 49th St Sioux Falls SD 57105-6581 |
| Practice Telephone | 6053128700 |
| Practice Fax Number | 6053128700 |
| Mailing Telephone | 6053128700 |
| Mailing Fax Number | 6053128700 |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2019-06-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | CP001529 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
CP001529 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2400 W 49TH ST |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-6581 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396764254 | Sanford Clinic | Psychiatry & Neurology | 2400 W 49th St, Sioux Falls, SD 57105-6581 | 2006-07-19 |
| 1841803806 | Tanya Marie Ochsner | Student in an Organized Health Care Education/Training Program | 2400 W 49th St, Sioux Falls, SD 57105-6581 | 2020-08-28 |
| 1871014639 | Kayla Nalan-sheffield | Psychologist | 2400 W 49th St, Sioux Falls, SD 57105-6581 | 2017-07-03 |
| 1427413038 | Barbara Wendell-schechter | Nurse Practitioner | 2400 W 49th St, Sioux Falls, SD 57105-6581 | 2015-12-24 |
| 1699163253 | Nichole Johnson | Nurse Practitioner | 2400 W 49th St, Sioux Falls, SD 57105-6581 | 2015-01-06 |
| 1023426806 | Mackenzie Mertz | Psychiatry & Neurology | 2400 W 49th St, Sioux Falls, SD 57105-6581 | 2014-07-24 |
| 1023428505 | Georgiana Nuss | Psychiatry & Neurology | 2400 W 49th St, Sioux Falls, SD 57105 | 2014-05-05 |
| 1992130033 | Serene Tate Thin Elk | Counselor | 2400 W 49th St, Sioux Falls, SD 57105 | 2013-09-09 |
| 1306125919 | Garet Ford | Physician Assistant | 2400 W 49th St, Sioux Falls, SD 57105-6581 | 2011-08-12 |
| 1134354764 | Sandra Milena Peynado Rojas | Psychiatry & Neurology | 2400 W 49th St, Sioux Falls, SD 57105-6581 | 2009-05-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871117549 | Ashlesha Ravindra Bagwe | Student in an Organized Health Care Education/Training Program | Pediatrics Residency Program, 1305 W 18th St, Rt 6364, Sioux Falls, SD 57105 | 2020-05-29 |
| 1306494489 | Kelsey Elaine Kruse | Counselor | 3101 West 41st, Sioux Falls, SD 57105 | 2019-08-30 |
| 1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
| 1235624727 | Mahum Shahid | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St, Sioux Falls, SD 57105 | 2018-06-27 |
| 1942790126 | Smitha Narayana Gowda | Student in an Organized Health Care Education/Training Program | 1400 22nd Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1326538554 | Mali Elizabeth Teller | Speech-Language Pathologist | 2501 W. 26th Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1871081505 | Abdelmohaymin Abdalla Abufatima Abdalla | Student in an Organized Health Care Education/Training Program | Usd-ssom-internal Medicine Residency, 1400 22nd Street, Sioux Falls, SD 57105 | 2018-04-27 |
| 1710474697 | Moataz Ellithi | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St., Sioux Falls, SD 57105 | 2018-04-17 |
| 1366948663 | Holly Ahlers | Registered Nurse | 2000 S. Summit Ave, Sioux Falls, Sd 57105, Sioux Falls, SD 57105 | 2018-04-04 |
| 1558864124 | Darcy Lee Jensen | Counselor | 822 East 41st. Street, Suite 235, Souix Falls, SD 57105 | 2018-03-09 |
| Find all providers in zip 57105 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437155132 | Family Institute of The Midwest | Nurse Practitioner | 520 W 22nd St, Sioux Falls, SD 57105-1702 | 2005-06-27 |
| 1790393825 | Anders Peterson | Nurse Practitioner | 4500 N Lewis Ave, Sioux Falls, SD 57104-7111 | 2020-07-15 |
| 1609494483 | Hannah Otten | Nurse Practitioner | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2020-07-08 |
| 1245886746 | Mitchell Jacob Relf | Nurse Practitioner | 4500 N Lewis Ave, Sioux Falls, SD 57104-7111 | 2019-08-12 |
| 1073167953 | Kenna Lyn Kennedy | Nurse Practitioner | 4500 N Lewis Ave, Sioux Falls, SD 57104-7111 | 2019-07-29 |
| 1124530860 | Ashley Lynn Jansen | Nurse Practitioner | 4510 N Lewis Ave, Sioux Falls, SD 57104-7111 | 2017-11-03 |
| 1538529904 | Thyra Crissey | Nurse Practitioner | 2501 W 22nd St, Sioux Falls, SD 57105-1305 | 2016-02-29 |
| 1598131831 | Amber Marie Reints | Nurse Practitioner | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2015-08-20 |
| 1699163253 | Nichole Johnson | Nurse Practitioner | 2400 W 49th St, Sioux Falls, SD 57105-6581 | 2015-01-06 |
| 1205144854 | Tracee A. Hofer | Nurse Practitioner | 4400 W. 69th St., Ste. 1500, Sioux Falls, SD 57108-8171 | 2010-09-16 |
| Find all providers in SIOUX FALLS | ||||
| City | SIOUX FALLS |
| Zip Code | 57105 |
Please comment or provide details below to improve the information on ANDRIA JO PETERSEN.
| 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.