TABITHA PETERSON (NPI# 1972986412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972986412 |
| Entity Type | Individual |
| Full Name | TABITHA PETERSON |
| Credential | PHARM.D. |
| Practice Address |
111 Pioneer Trl Chaska MN 55318-1121 |
| Mailing Address |
4663 Parkridge Dr Eagan MN 55123-2130 |
| Practice Telephone | 9523613766 |
| Mailing Telephone | 6513572125 |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2015-07-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 122330 | MN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720363658 | Tabitha Peterson | Counselor | 201 S Lakeline Blvd, Cedar Park, TX 78613-2718 | 2011-10-11 |
| Street Address |
111 PIONEER TRL |
| City | CHASKA |
| State | MN |
| Zip Code | 55318-1121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770524118 | Sadie M Christianson | Pharmacist | 111 Pioneer Trl, Chaska, MN 55318-1121 | 2006-06-09 |
| 1205226792 | Elizabeth Koloc | Pharmacy Technician | 111 Pioneer Trl, Chaska, MN 55318-1121 | 2015-02-04 |
| 1831596469 | Marty Ray Sandvig | Pharmacist | 111 Pioneer Trl, Chaska, MN 55318-1121 | 2014-11-25 |
| 1952663833 | Rachel Lynn Leier | Nurse Practitioner | 111 Pioneer Trl, Chaska, MN 55318-1121 | 2012-06-15 |
| 1619262094 | Jessica M Speers | Pharmacist | 111 Pioneer Trl, T-1352, Chaska, MN 55318 | 2011-06-14 |
| 1346534104 | Janel Marie Holm I | Pharmacist | 111 Pioneer Trl, T-1352, Chaska, MN 55318-1121 | 2011-06-08 |
| 1730473901 | Brenda Keske | Pharmacist | 111 Pioneer Trl, Chaska, MN 55318-1121 | 2011-06-06 |
| 1811295322 | Angela Arora Madan | Pharmacist | 111 Pioneer Trl, Chaska, MN 55318-1121 | 2011-03-08 |
| 1326248683 | Thomas M Dvorak | Physician Assistant | 111 Pioneer Trl, Chaska, MN 55318-1121 | 2007-07-24 |
| 1811066269 | Ulrick Eyecare, Inc. | Optometrist | 111 Pioneer Trl, Chaska, MN 55318-1121 | 2006-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548742968 | Elizabeth Ann Root | Counselor | 111 Hundertmark Rd Suite 450, Chaska, MN 55318 | 2018-09-01 |
| 1972002244 | Ruth Ann Plante | Counselor | 510 Chestnut Street Suite 201, Chaska, MN 55318 | 2018-02-01 |
| 1265959795 | Bhatti Gi Surgery Center LLC | Clinic/Center | 1447 White Oak Dr, Chaska, MN 55318 | 2017-08-25 |
| 1194241166 | Five Stars Recovery Center | Clinical Medical Laboratory | 1045 Stoughton Ave., Chaska, MN 55318 | 2017-08-21 |
| 1306383419 | Laurie Ann Sisser | Registered Nurse | 123 W. 3rd Street, Suite #1, Forever Life Home Health Care, Chaska, MN 55318 | 2017-01-26 |
| 1942756671 | David Erlandson | Physical Therapist | 110105 Pioneer Trail, #201, Chaska, MN 55318 | 2016-09-01 |
| 1912319286 | Chaska Commons Dental Group PC | Dentist | 114 Pioneer Trail, Chaska, MN 55318 | 2014-05-21 |
| 1063546620 | Laura Lee Bergjord | Social Worker | 600 East 4th St, Chaska, MN 55318 | 2007-03-15 |
| 1184758740 | Jennifer Ann Mueller | Social Worker | 401 East Fourth Street, Chaska, MN 55318 | 2007-03-15 |
| 1487785234 | The Salvation Army Harbor Light Center Beacon Program | Substance Abuse Rehabilitation Facility | 11065 Village Road, Chaska, MN 55318 | 2007-03-07 |
| Find all providers in zip 55318 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770524118 | Sadie M Christianson | Pharmacist | 111 Pioneer Trl, Chaska, MN 55318-1121 | 2006-06-09 |
| 1831596469 | Marty Ray Sandvig | Pharmacist | 111 Pioneer Trl, Chaska, MN 55318-1121 | 2014-11-25 |
| 1013286566 | Joseph L Wessels | Pharmacist | 3110 Chaska Blvd, Chaska, MN 55318-2275 | 2011-12-28 |
| 1356627830 | Taryn Teresa Ishaug | Pharmacist | 3110 Chaska Blvd, Chaska, MN 55318-2275 | 2011-10-27 |
| 1598041519 | Megan Elizabeth Flynn | Pharmacist | 3110 Chaska Blvd, Chaska, MN 55318-2275 | 2011-10-24 |
| 1871879825 | Brian Eric Reishus | Pharmacist | 3110 Chaska Blvd, Chaska, MN 55318-2275 | 2011-10-21 |
| 1518242593 | Chelsey Morgan Strand | Pharmacist | 3110 Chaska Blvd, Chaska, MN 55318-2275 | 2011-10-20 |
| 1740577303 | Stephanie Amber Redmond | Pharmacist | 111 Hundertmark Rd Ste 115n, Chaska, MN 55318-1584 | 2011-07-05 |
| 1619262094 | Jessica M Speers | Pharmacist | 111 Pioneer Trl, T-1352, Chaska, MN 55318 | 2011-06-14 |
| 1346534104 | Janel Marie Holm I | Pharmacist | 111 Pioneer Trl, T-1352, Chaska, MN 55318-1121 | 2011-06-08 |
| Find all providers in CHASKA | ||||
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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.