JERIANN C PETER (NPI# 1639405434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639405434 |
| Entity Type | Individual |
| Full Name | JERIANN C PETER |
| Other Name | JERIANN C KLINE |
| Credential | FNP |
| Practice Address |
1515 Eubank Albuquerque NM 87185 |
| Mailing Address |
Po Box 5800 Ms 1019 Albuquerque NM 87185-1019 |
| Practice Telephone | 5058459025 |
| Mailing Telephone | 5058459025 |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2018-09-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 2005021426 | MO | Nursing Service Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
2005021426 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
2005021426 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1639405434 | 05 | |
| IL | 1639405434 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2 Progress Point Ct, O Fallon, MO 63368 | 3143170600 | 3143170606 |
| Street Address |
1515 EUBANK |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87185 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811540834 | Angie Leigh Avila-quigley | Registered Nurse | 1515 Eubank, Albuquerque, NM 87117 | 2019-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225425127 | Laura Tenorio | Case Manager/Care Coordinator | 1515 Eubank Se, Abq, NM 87185 | 2015-04-20 |
| 1962755009 | Denise Provoost | Physical Therapy Assistant | 1515 Eubank Blvd Se Bldg 832, Albuquerque, NM 87185 | 2012-10-25 |
| 1790162253 | Gina Marie Madison | Health Educator | 1515 Eubank Blvd Se Bldg. 831-832, Albuquerque, NM 87185-1019 | 2015-05-04 |
| 1609124999 | Dean M Klassy Sr. | Technician, Other | 1515 Eubank Blvd, Bldg 831/831, Albuquerque, NM 87185-1019 | 2012-08-17 |
| 1366797011 | Pierre Gerard Delmarcelle | Health Educator | 1515 Eubank Blvd Se 831/832, Albuquerque, NM 87185-1019 | 2012-07-18 |
| 1144612730 | Marena Pacheco | Dietitian, Registered | 1515 Eubank Blvd Se Bldg. 831/832, Albuquerque, NM 87185-1019 | 2015-02-19 |
| 1699166140 | Sandia National Laboratories | Clinic/Center | 1515 Eubank Blvd Se Bldg. 831/832, Albuquerque, NM 87185-1019 | 2015-02-05 |
| 1962758409 | Michael Anthony Romo | Emergency Medical Technician, Paramedic | 1515 Eubank Blvd Se, Bldg. 831/832, Albuquerque, NM 87185-1019 | 2012-08-02 |
| 1700132651 | Linda Marie Manke | Registered Nurse | 1515 Eubank Se, Bldg. 831/832, Albuquerque, NM 87185-1019 | 2012-07-30 |
| 1356697296 | Kathleen Marie Peterson | Registered Nurse | 1515 Eubank Blvd Se, Bldg. 831/832, Albuquerque, NM 87185-1019 | 2012-07-30 |
| Find all providers in zip 87185 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942808126 | Compassion Docs LLC | Nurse Practitioner | 8100 Wyoming Blvd Ne Ste M-4302, Albuquerque, NM 87113-1946 | 2020-10-11 |
| 1598398216 | Melissa Rose Pino | Nurse Practitioner | 10855 Firenze Dr Nw, Albuquerque, NM 87114-5287 | 2020-02-20 |
| 1043857410 | Elizabeth F Baca | Nurse Practitioner | 2502 Marble Ave, Albuquerque, NM 87131-0001 | 2019-12-04 |
| 1356358477 | Mary Louise Blankenship | Nurse Practitioner | 3200 La Orilla Rd Nw, Albuquerque, NM 87120-2742 | 2006-08-02 |
| 1023620143 | Chona Miller | Nurse Practitioner | 1500 Lomas Blvd Nw, Albuquerque, NM 87104-1200 | 2020-08-19 |
| 1831708924 | Pala Nicole Rivera | Nurse Practitioner | 1110 Pennsylvania St Ne Ste B, Albuquerque, NM 87110-7404 | 2020-07-24 |
| 1821621004 | Marlo Rose Gonzales | Nurse Practitioner | 4588 Paradise Blvd Nw, Albuquerque, NM 87114-4105 | 2020-02-17 |
| 1205398484 | Deborah Anne Ruiz | Nurse Practitioner | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2019-04-04 |
| 1184196446 | Dawn Annmarie Vigil | Nurse Practitioner | 401 San Mateo Blvd Se, Albuquerque, NM 87108-2921 | 2018-12-27 |
| 1356811384 | Jacqueline Messier | Nurse Practitioner | 2929 Coors Blvd Nw, Albuquerque, NM 87120-1173 | 2018-12-03 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87185 |
Please comment or provide details below to improve the information on JERIANN C PETER.
| 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.