PRESTON LEE PETERSON (NPI# 1801453030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801453030 |
| Entity Type | Individual |
| Full Name | PRESTON LEE PETERSON |
| Credential | AGACNP |
| Practice Address |
1500 E 2nd St Ste 100 Reno NV 89502-1189 |
| Mailing Address |
850 Harvard Way Reno NV 89502-2055 |
| Practice Telephone | 7759825003 |
| Mailing Telephone | 7759825262 |
| Mailing Fax Number | 7759825496 |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2019-08-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
822824 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
822824 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245201508 | Preston Lane Peterson | Internal Medicine | 2701 Nw Vaughn St, Suite 160, Portland, OR 97210-5311 | 2006-01-26 |
| Street Address |
1500 E 2ND ST STE 100 |
| City | RENO |
| State | NV |
| Zip Code | 89502-1189 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427149194 | Martin J Naughton | Specialist | 1500 E 2nd St Ste 100, Reno, NV 89502-1189 | 2006-09-27 |
| 1144870767 | Nicole Michiko Hunt | Nurse Practitioner | 1500 E 2nd St Ste 100, Reno, NV 89502-1189 | 2019-09-16 |
| 1518479302 | Alexandra Sidorski | Nurse Practitioner | 1500 E 2nd St Ste 100, Reno, NV 89502-1189 | 2017-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314264 | State of Nevada | Community/Behavioral Health | 4600 Kietzke Lane Bldg D, Reno, NV 89502 | 2020-07-23 |
| 1447879259 | Ryan Johnson | Student in an Organized Health Care Education/Training Program | 1155 Mill St. W-11, Reno, NV 89502 | 2020-04-11 |
| 1396378063 | Domingko Loney | Chore Provider | 1325 Air Motive Wat St 262, Reno, NV 89502 | 2020-02-20 |
| 1053954842 | Derek Craig | Home Health Aide | 1000 Havard Way #29, Reno, NV 89502 | 2019-10-24 |
| 1477108124 | Marisa Rachael Traversie | Nurse Practitioner | 910 Vista Boulevard, Sparks, NV 89502 | 2019-08-08 |
| 1912564675 | Patrick Llewellyn Merrill | Social Worker | 975 Kirman Ave - Ch 116, Reno, NV 89502 | 2019-05-28 |
| 1881154706 | Naresh Kumar Veerabattini | Student in an Organized Health Care Education/Training Program | 1155 Mill St, Renown Regional Medical Center, W11 Academic Department Offices, Reno, NV 89502 | 2019-03-25 |
| 1053899187 | Daphne London | Behavioral Analyst | 1325 Airmotive Way Ste 260, Reno, NV 89502 | 2018-07-31 |
| 1790271609 | Jennifer J Padolina | Optometrist | 2296 Kietzke Ln, Reno, NV 89502 | 2018-07-03 |
| 1336630185 | Lindsey Cherie Cooper | Technician | 3563 Sol Grande Ct, Reno, NV 89502 | 2018-05-27 |
| Find all providers in zip 89502 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184241226 | Jillian Rose Castillo | Nurse Practitioner | 1005 Terminal Way Ste 184, Reno, NV 89502-2179 | 2020-07-05 |
| 1225048184 | Charles A Sheeley II | Nurse Practitioner | 50 Kirman Ave, Reno, NV 89502-1175 | 2006-08-09 |
| 1336150275 | Brenda Ann Pugsley | Nurse Practitioner | 5250 Neil Rd., #207, Reno, NV 89502-6556 | 2006-08-09 |
| 1053931386 | Jennifer Leilani Griffo | Nurse Practitioner | 1500 E 2nd St Ste 400, Reno, NV 89502-1198 | 2020-04-16 |
| 1265081756 | Deanna M. Whitehorn | Nurse Practitioner | 3101 Plumas St, Reno, NV 89509-4515 | 2019-09-06 |
| 1700364338 | Rachel A Chattin | Nurse Practitioner | 5590 Kietzke Ln, Reno, NV 89511-3019 | 2018-08-06 |
| 1811416738 | Ann Egan | Nurse Practitioner | 5560 Kietzke Ln Bldg A, Reno, NV 89511 | 2017-09-12 |
| 1619337573 | Caleb Frink | Nurse Practitioner | 1155 Mill St, Reno, NV 89502-1576 | 2016-03-03 |
| 1669483327 | Laura J Sheeley | Nurse Practitioner | 50 Kirman Ave, Reno, NV 89502-1175 | 2006-08-10 |
| 1972537645 | Jeannine Clark | Nurse Practitioner | 1000 Locust St, Reno, NV 89502-2597 | 2006-07-10 |
| Find all providers in RENO | ||||
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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.