LARISSA KANEESHA PETERSON (NPI# 1225506397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225506397 |
| Entity Type | Individual |
| Full Name | LARISSA KANEESHA PETERSON |
| Practice Address |
422 Garrisonville Rd Ste 111 Stafford VA 22554-1573 |
| Practice Telephone | 5407208000 |
| Mailing Telephone | 5407208000 |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2018-11-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024176854 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
422 GARRISONVILLE RD STE 111 |
| City | STAFFORD |
| State | VA |
| Zip Code | 22554-1573 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316556178 | Zachary Scott Getz | Nurse Practitioner | 422 Garrisonville Rd Ste 111, Stafford, VA 22554-1573 | 2020-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699385658 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 1640 Publix Way, Stafford, VA 22554 | 2020-08-05 |
| 1700368156 | Aws Altameemi | Dentist | 392 Garrisonville Road 205, Stafford, VA 22554 | 2018-09-02 |
| 1831680214 | Radka Loucka | Counselor | 2124 Jefferson Davis Highway, Suite 202, Stafford, VA 22554 | 2018-05-22 |
| 1205383718 | Ogiawesome | Non-emergency Medical Transport (VAN) | 109 Chesterbrook Court, Stafford, VA 22554 | 2016-09-01 |
| 1184088502 | Inina Plucer-rosario | Behavioral Analyst | 12 Monument Drive, Stafford, VA 22554 | 2016-04-12 |
| 1528451218 | Insight Psychological Services, Pllc | Counselor | 11 Hope Rd., Suite 213, Stafford, VA 22554 | 2015-03-05 |
| 1194142885 | Krystal Karin Edmonds | Behavioral Analyst | 538 Apricot Street, Stafford, VA 22554 | 2014-03-20 |
| 1851715312 | Maryann Byrne | Counselor | 108 Brandice St, Stafford, VA 22554 | 2014-02-04 |
| 1164857272 | Melissa C Keylor | Counselor | 11 Hope Road, Suite 213, Stafford, VA 22554 | 2013-09-09 |
| 1255777959 | Sophia Rodrigues | Physical Therapist | 2777 Jefferson Davis Hwy, Suite 109, Performance Physical Therapy, Stafford, VA 22554 | 2013-05-21 |
| Find all providers in zip 22554 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659996817 | Kafayat T Adigun | Nurse Practitioner | 1011 Allisa St, Stafford, TX 77477-4625 | 2020-06-13 |
| 1811518962 | Olguine Theard-chery | Nurse Practitioner | 9 Short Branch Rd, Stafford, VA 22556-4635 | 2020-04-29 |
| 1992356414 | Rachael Ann Johnson Anderson | Nurse Practitioner | 1208 Brent Point Rd, Stafford, VA 22554-3313 | 2019-09-25 |
| 1588220255 | Christiana Bangura | Nurse Practitioner | 422 Garrisonville Rd Ste 103, Stafford, VA 22554-1573 | 2019-05-17 |
| 1417416546 | Diversity Healthcare Services Inc. | Nurse Practitioner | 12818 Century Dr Ste 106, Stafford, TX 77477-4224 | 2019-03-18 |
| 1306310214 | Pizzazz Healthcare Systems | Nurse Practitioner | 618 Wheelhouse Dr, Stafford, TX 77477-5828 | 2019-01-14 |
| 1891274296 | Erika Jonte Martin | Nurse Practitioner | 4800 Sugar Grove Blvd Ste 390, Stafford, TX 77477-2631 | 2018-08-07 |
| 1891214508 | Lakeshia Evans | Nurse Practitioner | 215 Freesia Ln, Stafford, VA 22554-2532 | 2017-09-13 |
| 1467970244 | Gwendolyn S Black | Nurse Practitioner | 4800 Sugar Grove Blvd Ste 540, Stafford, TX 77477-2150 | 2017-08-31 |
| 1598292930 | Melanie Deshawn Ceasar-amponsah | Nurse Practitioner | 318 Leisure Dr, Stafford, TX 77477-5830 | 2017-05-16 |
| Find all providers in STAFFORD | ||||
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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.