CAROL PEITZMAN (NPI# 1225120991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225120991 |
| Entity Type | Individual |
| Full Name | CAROL PEITZMAN |
| Credential | M.D. |
| Practice Address |
1603 W Old Shakopee Rd Bloomington MN 55431-3065 |
| Practice Telephone | 9524014868 |
| Practice Fax Number | 8888167903 |
| Mailing Telephone | 9524014868 |
| Mailing Fax Number | 8888167903 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2013-07-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
P78919 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1603 W OLD SHAKOPEE RD |
| City | BLOOMINGTON |
| State | MN |
| Zip Code | 55431-3065 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679684203 | Colleen S Odonnell | Nurse Practitioner | 1603 W Old Shakopee Rd, Bloomington, MN 55431-3065 | 2006-08-31 |
| 1003172594 | Mount Olivet Rolling Acres, Inc | Clinical Nurse Specialist | 1603 W Old Shakopee Rd, Bloomington, MN 55431-3065 | 2012-04-09 |
| 1790975928 | Stephani Louise Bruyer | Psychologist | 1603 W Old Shakopee Rd, Bloomington, MN 55431-3065 | 2007-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162509 | Mckenzie Mcadaragh | Nurse Practitioner | 10924 Girard Curve, Bloomington, MN 55431 | 2020-10-21 |
| 1760042253 | Adams Health Care Services, LLC | Registered Nurse | 10036 Washburn Ave S, Bloomington, MN 55431 | 2019-06-17 |
| 1851864755 | Hope Autism Center | Day Training, Developmentally Disabled Services | 9333 Penn Ave S, Bloomington, MN 55431 | 2019-01-03 |
| 1275006215 | Cameron Lee Small | Counselor | 9156 Vincent Ave S, Bloomington, MN 55431 | 2019-01-02 |
| 1497240469 | Mikayla Slegh | Behavior Technician | 8200 Humboldt Ave S Suite 100, Bloomington, MN 55431 | 2018-06-22 |
| 1073061552 | David Wells | Nurse Practitioner | 8100 Northland Dr., Bloomington, MN 55431 | 2016-09-14 |
| 1780033076 | Yasin Jama | Contractor | 9810 Drew Avenue South, Apartment 106, Bloomington, MN 55431 | 2016-06-07 |
| 1972961001 | Kadar Hadis | Social Worker | 8200 Humboldt Ave S Ste 217, Bloomington, MN 55431 | 2016-02-03 |
| 1063878908 | Amazing Transportation Services, LLC | Non-emergency Medical Transport (VAN) | 9031 Penn Ave South Suite 100, Bloomington, MN 55431 | 2016-01-07 |
| 1093170136 | Kelsey Margaret Perreault | Chiropractor | 8120 Penn Ave. S., Suite 525, Bloomington, MN 55431 | 2015-12-16 |
| Find all providers in zip 55431 | ||||
| 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 |
|---|---|---|---|---|
| 1134780851 | Eric Lyakhovetsky | Nurse Practitioner | 327 W Saidah Rd, Bloomington, IN 47404-8965 | 2019-06-24 |
| 1477822344 | Wenjing Cao | Nurse Practitioner | 108 W. Market, Bloomington, IL 61701 | 2011-12-22 |
| 1679684203 | Colleen S Odonnell | Nurse Practitioner | 1603 W Old Shakopee Rd, Bloomington, MN 55431-3065 | 2006-08-31 |
| 1558970517 | Randy Bargo | Nurse Practitioner | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2020-07-27 |
| 1750921870 | Lotus Integrated Care, LLC | Nurse Practitioner | 654 S Walker St, Bloomington, IN 47403-2159 | 2020-01-07 |
| 1033768569 | Amanda Lavender | Nurse Practitioner | 727 W 2nd St, Bloomington, IN 47403-2209 | 2019-09-07 |
| 1396215786 | Hui Shi Serena Loh | Nurse Practitioner | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2018-11-28 |
| 1922583285 | Bettina Ervin-rodgers | Nurse Practitioner | 108 W Market St, Bloomington, IL 61701-3918 | 2018-10-02 |
| 1710479753 | Kevin Nelson Moore | Nurse Practitioner | 550 S Adams St, Bloomington, IN 47403 | 2018-06-05 |
| 1205287513 | Stephanie B. Pemberton | Nurse Practitioner | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2016-06-28 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 55431 |
Please comment or provide details below to improve the information on CAROL PEITZMAN.
| 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.