JO A PETERSON (NPI# 1073584371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073584371 |
| Entity Type | Individual |
| Full Name | JO A PETERSON |
| Credential | WHCNP |
| Practice Address |
310 Belle Ave Mankato MN 56001-5287 |
| Mailing Address |
617 Baker Ave Mankato MN 56001-2502 |
| Practice Telephone | 5073875581 |
| Mailing Telephone | 5073453287 |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
R090431-3 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICA | 07-02759 | 01 | |
| AMERICA'S PPO (ARAZ) | 1069924 | 01 | |
| UCARE | 111464 | 01 | |
| MN | BCBS MN | 615S9PE | 01 |
| HEALTH PARTNERS | HP21605 | 01 | |
| SIOUX VALLEY HEALTH PLAN | 20342 | 01 | |
| PREFERRED ONE | 1016958 | 01 |
| Street Address |
310 BELLE AVE |
| City | MANKATO |
| State | MN |
| Zip Code | 56001-5287 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831178292 | Planned Parenthood Minnesota, North Dakota, South Dakota | Specialist | 310 Belle Ave, Mankato, MN 56001-5287 | 2006-01-13 |
| 1992986186 | Terrie Ziegler | Audiologist | 310 Belle Ave, Mankato, MN 56001-5287 | 2007-11-16 |
| 1902852874 | Richard Musselman | Hearing Instrument Specialist | 310 Belle Ave, Mankato, MN 56001-5287 | 2006-05-25 |
| 1750334397 | Sonus-usa, Inc | Audiologist-Hearing Aid Fitter | 310 Belle Ave, Mankato, MN 56001-5287 | 2006-05-17 |
| 1144290685 | Marlys A Anderson | Nurse Practitioner | 310 Belle Ave, Mankato, MN 56001-5287 | 2006-01-26 |
| 1144290719 | Lynda K Kruckeberg | Nurse Practitioner | 310 Belle Ave, Mankato, MN 56001-5287 | 2006-01-25 |
| 1063482941 | Lisa Bratsch-montag | Nurse Practitioner | 310 Belle Ave, Mankato, MN 56001-5287 | 2006-01-24 |
| 1114997004 | Virginia C Clementson | Nurse Practitioner | 310 Belle Ave, Mankato, MN 56001-5287 | 2006-01-24 |
| 1649240458 | Karen S Delesha | Nurse Practitioner | 310 Belle Ave, Mankato, MN 56001-5287 | 2006-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134647274 | Lisa Bergman | Nurse Practitioner | 201 N Victory Dr Ste 211, Mankato, MN 56001-5398 | 2017-09-08 |
| 1891765293 | Susan E Dunn | Nurse Practitioner | 1230 E Main St, Mankato, MN 56001 | 2006-01-26 |
| 1144290685 | Marlys A Anderson | Nurse Practitioner | 310 Belle Ave, Mankato, MN 56001-5287 | 2006-01-26 |
| 1144290719 | Lynda K Kruckeberg | Nurse Practitioner | 310 Belle Ave, Mankato, MN 56001-5287 | 2006-01-25 |
| 1063482941 | Lisa Bratsch-montag | Nurse Practitioner | 310 Belle Ave, Mankato, MN 56001-5287 | 2006-01-24 |
| 1114997004 | Virginia C Clementson | Nurse Practitioner | 310 Belle Ave, Mankato, MN 56001-5287 | 2006-01-24 |
| 1649240458 | Karen S Delesha | Nurse Practitioner | 310 Belle Ave, Mankato, MN 56001-5287 | 2006-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013547850 | Lexie Frances Polk | Nurse Practitioner | 3520 N Shore Dr, Wayzata, MN 55391-9360 | 2020-01-21 |
| 1790341865 | Natalie Nicole Johnson | Nurse Practitioner | 9550 Upland Ln N Ste 230, Maple Grove, MN 55369-4484 | 2019-05-14 |
| 1326519646 | Kelsey M Thompson | Nurse Practitioner | 2920 Aldrich Ave S Apt 145, Minneapolis, MN 55408-4275 | 2018-12-13 |
| 1528450053 | Stephanie Nielsen | Nurse Practitioner | 1979 Sotlich Rd, Ely, MN 55731-8239 | 2015-02-20 |
| 1366842734 | Meghan Stommes | Nurse Practitioner | 801 Nicollet Mall Ste 400, Minneapolis, MN 55402-2520 | 2014-09-03 |
| 1659710887 | Jessica Williams | Nurse Practitioner | 451 E Saint Germain St Ste 100, Saint Cloud, MN 56304-0761 | 2013-06-20 |
| 1437496700 | Toby Faye Sawyer | Nurse Practitioner | 1001 E Central Entrance Ste 200, Duluth, MN 55811-5525 | 2013-01-07 |
| 1093096927 | Laura J Wilner | Nurse Practitioner | 803 Belsly Blvd # 2, Moorhead, MN 56560-5057 | 2011-09-06 |
| 1861720062 | Linda Marie Christinsen-rengel | Nurse Practitioner | 640 Jackson Street Ms 11101a, Healthpartners Regions Specialty Clinics, Saint Paul, MN 55101 | 2009-11-27 |
| 1831328756 | Health Empowerment Institute | Nurse Practitioner | 2512 W Broadway Ave, Minneapolis, MN 55411-1737 | 2009-07-13 |
| Find all providers with the same taxonomy | ||||
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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.