KOURTNEY PETERSON (NPI# 1093165227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093165227 |
| Entity Type | Individual |
| Full Name | KOURTNEY PETERSON |
| Practice Address |
3330 Nw 56th St Suite 208 Oklahoma City OK 73112-4479 |
| Practice Telephone | 4056040688 |
| Mailing Telephone | 4056040688 |
| Enumeration Date | 2016-06-19 |
| Last Update Date | 2017-04-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 104671 | OK | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
104671 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3330 NW 56TH ST SUITE 208 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73112-4479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881697761 | Georgianne M Snowden | Radiology | 3330 Nw 56th St, Ste 206, Oklahoma City, OK 73112-4426 | 2005-05-24 |
| 1013444298 | Essential Integrative Health Pllc | Phlebology | 3330 Nw 56th St, Suite 612, Oklahoma City, OK 73112-4479 | 2017-05-18 |
| 1548615081 | Tricia Strahorn | Dietitian, Registered | 3330 Nw 56th St, Suite 106, Oklahoma City, OK 73112-4479 | 2016-05-03 |
| 1972963353 | Frontier Health Services, LLC | Internal Medicine | 3330 Nw 56th St, Oklahoma City, OK 73112-4479 | 2016-02-29 |
| 1114394251 | Shamika Mack | Nurse Practitioner | 3330 Nw 56th St, Suite 300, Oklahoma City, OK 73112-4479 | 2015-08-24 |
| 1114300316 | Matthew Munda | Nurse Practitioner | 3330 Nw 56th St, Suite 612, Oklahoma City, OK 73112-4479 | 2015-07-07 |
| 1689070047 | Dr. Scott L. Shields, P.C. | Podiatrist | 3330 Nw 56th St, Suite 600, Oklahoma City, OK 73112-4479 | 2014-11-13 |
| 1649672031 | Ashton Nicole Miller | Registered Nurse | 3330 Nw 56th St, Suite 300, Oklahoma City, OK 73112-4479 | 2014-09-17 |
| 1053712737 | David G. Wade Dpm Pllc | Podiatrist | 3330 Nw 56th St, #600, Oklahoma City, OK 73112-4479 | 2014-09-12 |
| 1487064887 | Osu Center for Health Sciences | Clinic/Center | 3330 Nw 56th St, Suite 206, Oklahoma City, OK 73112-4479 | 2014-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972145886 | Crystopher J Long | Physical Therapist | Parkway Post Acute Recovery Center, 6312 N Portland, Oklahoma City, OK 73112 | 2019-10-11 |
| 1700448974 | Joy Healthcare Services of Okc LLC | Home Health | 4200 Perimeter Center Drive, Suite 125, Oklahoma City, OK 73112 | 2019-07-08 |
| 1801380159 | Crysten Cheatwood Do, PC | Obstetrics & Gynecology | 3433 Nw 56 Street, Suite 210b, Oklahoma City, OK 73112 | 2018-06-20 |
| 1306352521 | Victoria Ann Kappel | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3466 Nw 56th St. Suite 760, Oklahoma City, OK 73112 | 2017-12-26 |
| 1871014886 | Tanesia Michelle Smith | Case Management | 2629 W I44 Service Rd, Suite 202, Oklahoma City, OK 73112 | 2017-06-29 |
| 1619414257 | Edwige Gwanyama | Student in an Organized Health Care Education/Training Program | 2401 Nw 39 Th Expy Ste 103, Oklahoma City, OK 73112 | 2017-01-20 |
| 1619424017 | Jennifer Beaver | Peer Specialist | 2808 Nw 31st, Oklahoma City, OK 73112 | 2016-09-02 |
| 1417305368 | Gabriel Plank | Counselor | 3000 Founders Blvd Suite239, Oklahoma City, OK 73112 | 2016-06-01 |
| 1912364365 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 4101 N May Ave, Oklahoma City, OK 73112 | 2016-01-15 |
| 1679938922 | Portland Anesthesia Associates LLC | Nurse Anesthetist, Certified Registered | 5501 N Porland Ave, Oklahoma City, OK 73112 | 2015-12-30 |
| Find all providers in zip 73112 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700483302 | Terri Lynn Quintero | Nurse Practitioner | 15701 S Pennsylvania Ave, Oklahoma City, OK 73170-8713 | 2020-10-06 |
| 1952917239 | Philomina Philipose | Nurse Practitioner | 8805 Nw 116th St, Oklahoma City, OK 73162-2220 | 2020-09-21 |
| 1376158295 | Ligi Abraham | Nurse Practitioner | 4200 W Memorial Rd Ste 206, Oklahoma City, OK 73120-8305 | 2020-09-09 |
| 1487266532 | Carla Jo Walker | Nurse Practitioner | 1325 N Walker Ave Apt 357, Oklahoma City, OK 73103-6409 | 2020-08-20 |
| 1396356143 | Deshell Ravette Tillman | Nurse Practitioner | 2621 N Sterling Ave, Oklahoma City, OK 73127-1919 | 2020-08-14 |
| 1225656549 | Simon Wellness LLC | Nurse Practitioner | 9321 Sw 23rd St, Oklahoma City, OK 73128-1840 | 2020-07-13 |
| 1831717396 | Caitlin Raylynn Stenberg | Nurse Practitioner | 1000 N Lincoln Blvd Ste 3200, Oklahoma City, OK 73104-3252 | 2020-07-10 |
| 1467078113 | Jaanki Bhakta | Nurse Practitioner | 9116 Sw 24th St, Oklahoma City, OK 73128-4903 | 2020-06-18 |
| 1629699244 | Tanya Cates | Nurse Practitioner | 5529 Bush Creek Way, Oklahoma City, OK 73117-8440 | 2020-05-05 |
| 1922629054 | Heather Amanda Chin Hwa Rutledge | Nurse Practitioner | 7800 Sw 87th Cir, Oklahoma City, OK 73169-7800 | 2020-04-29 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73112 |
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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.