MS. MARCIA KAY PETERZELL (NPI# 1598919714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598919714 |
| Entity Type | Individual |
| Full Name | MS. MARCIA KAY PETERZELL |
| Other Name | MISS MARCIA KAY ERHARDT |
| Credential | APRN |
| Practice Address |
1275 W Granada Blvd. Ste 3a Coastal Pediatrics LLC Ormond Beach FL 32174 |
| Mailing Address |
1275 W Granada Blvd Ste 3a Coastal Pediatrics LLC Ormond Beach FL 32174 |
| Practice Telephone | 3866721490 |
| Practice Fax Number | 3866721682 |
| Mailing Telephone | 3866721490 |
| Mailing Fax Number | 3866721682 |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2020-01-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
APRN3136772 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | STOFFL/DOH | ARNP3136772 | 01 |
| Street Address |
1275 W GRANADA BLVD. STE 3A COASTAL PEDIATRICS LLC |
| City | ORMOND BEACH |
| State | FL |
| Zip Code | 32174 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215574991 | Case Vision Pa | Optometrist | Eye Savers, 1474 W. Granada Blvd. #470, Ormond Beach, FL 32174 | 2019-12-02 |
| 1235797143 | Galia Leilani Medrano Ramirez | Dentist | 1274 W. Granada Blvd, Ormond Beach, FL 32174 | 2019-06-05 |
| 1295299220 | Jessica Johnson Hills | Nurse Practitioner | 1400 Hand Ave Ste K, Ormond Beach, FL 32174 | 2019-01-23 |
| 1437507043 | Natasha Jairam | Family Medicine | Adventhealth Medical Group Family Medicine, 400 Clyde Morris Blvd Ste A, Ormond Beach, FL 32174 | 2016-05-25 |
| 1871956540 | Lisa Anne Parissi | Chiropractor | 157 Kimberly Drive, Ormond Beach, FL 32174 | 2016-03-31 |
| 1023477940 | Ambassador Health Services, Inc | In Home Supportive Care | 136 N Orchard St Ste 1, Ormond Beach, FL 32174 | 2016-02-19 |
| 1619341518 | Maria Rogers | Optometrist | 9 Abacus Ave, Ormond Beach, FL 32174 | 2015-11-16 |
| 1285003830 | Sydney Kalin Neuhardt | Nurse Practitioner | 725 W. Granada Blvd. Ste 1, Ormond Beach, FL 32174 | 2015-09-24 |
| 1194107821 | Jerusha Thacker | Case Manager/Care Coordinator | 259 Bill France Blvd. Ste 200, Daytona Beach, FL 32174 | 2015-06-18 |
| 1730569971 | Daniel Joseph Lapolla | Physical Therapy Assistant | 1275 Granada Blvd, Suite 4b2, Ormond Beach, FL 32174 | 2015-06-03 |
| Find all providers in zip 32174 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396128989 | Kristen Marie Combs | Nurse Practitioner | 200 Booth Rd Ste A, Ormond Beach, FL 32174-5716 | 2015-07-01 |
| 1376620534 | Bernavette Pamela Perry | Nurse Practitioner | 565 Memorial Cir, Ormond Beach, FL 32174-5001 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417072 | Carmen Moreno | Nurse Practitioner | 336 Golfview Rd Apt 909, North Palm Beach, FL 33408-3512 | 2020-11-05 |
| 1366043614 | Christi Koshy | Nurse Practitioner | 4025 N Nob Hill Rd Apt 207, Sunrise, FL 33351-5811 | 2020-11-03 |
| 1730789322 | Michelle Yen-vera | Nurse Practitioner | 18409 Nw 9th Ct, Pembroke Pines, FL 33029-3607 | 2020-11-01 |
| 1376143487 | Aimee N Jorgenson Stough | Nurse Practitioner | 91550 Overseas Hwy Ste 209, Tavernier, FL 33070-2513 | 2020-10-28 |
| 1588271233 | Olivia Janelle De Jong | Nurse Practitioner | 424 Ne 6th St Apt D, Gainesville, FL 32601-5576 | 2020-09-28 |
| 1801407796 | Elisabeth Morley Chinlund | Nurse Practitioner | 445 Delmar Ter S Apt 5, Saint Petersburg, FL 33701-4653 | 2020-08-13 |
| 1972113025 | Nicole Horn | Nurse Practitioner | 8095 Spyglass Hill Rd Ste 104, Melbourne, FL 32940-8290 | 2020-08-04 |
| 1073131850 | Olivia Dawn Wilson | Nurse Practitioner | 5105 Clover Mist Dr, Apollo Beach, FL 33572-3417 | 2020-07-08 |
| 1427687565 | Cortney M Starr | Nurse Practitioner | 2261 Kingfisher Ln, Clearwater, FL 33762-3323 | 2020-04-01 |
| 1285263335 | Summer Leigh Moran | Nurse Practitioner | 528 W Baldwin Rd # A, Panama City, FL 32405-3313 | 2020-04-01 |
| Find all providers with the same taxonomy | ||||
| City | ORMOND BEACH |
| Zip Code | 32174 |
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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.