NICOLE SHEREE PETERSON (NPI# 1144694068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144694068 |
| Entity Type | Individual |
| Full Name | NICOLE SHEREE PETERSON |
| Credential | PA-C |
| Practice Address |
1551 Renaissance Towne Dr Ste 400 Bountiful UT 84010-7676 |
| Practice Telephone | 8012957200 |
| Practice Fax Number | 8012954930 |
| Mailing Telephone | 8012957200 |
| Mailing Fax Number | 8012954930 |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2015-11-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 9495419-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851956072 | Nicole Peterson | Acupuncturist | 208 Oak St Ste 106e, Ashland, OR 97520-1871 | 2019-05-02 |
| 1366882938 | Nicole Yvette Peterson | Behavioral Analyst | 278 Marty Dr, Manteca, CA 95336-3450 | 2013-06-27 |
| 1225017734 | Nicole E Peterson | Physical Therapist | 1245 15th St N, Saint Cloud, MN 56303-1802 | 2006-01-12 |
| 1114540564 | Nicole Peterson | Physician Assistant | 3620 N 3rd St, Phoenix, AZ 85012-2020 | 2020-05-20 |
| 1538780697 | Nicole Peterson | Behavior Technician | 233 S 13th St Ste 1100, Lincoln, NE 68508-2003 | 2020-04-29 |
| 1518511492 | Nicole Peterson | Registered Nurse | 1200 Collins Ave, Mandan, ND 58554-2066 | 2019-07-29 |
| 1548738743 | Nicole Peterson | Case Manager/Care Coordinator | 2600 W 9th St, Chester, PA 19013-2040 | 2018-11-06 |
| 1114411568 | Nicole Arlene Peterson | Case Manager/Care Coordinator | 682 Briergate Way, Hayward, CA 94544-7245 | 2018-06-19 |
| 1639603913 | Nicole Marie Peterson | Nurse Practitioner | 2251 N Shore Dr, Rhinelander, WI 54501 | 2017-04-13 |
| 1821547621 | Nicole Peterson | Pharmacist | 1201 W Crawford St, Salina, KS 67401-4657 | 2016-09-22 |
| Street Address |
1551 RENAISSANCE TOWNE DR STE 400 |
| City | BOUNTIFUL |
| State | UT |
| Zip Code | 84010-7676 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538331871 | Christopher Steven English | Orthopaedic Surgery | 1551 Renaissance Towne Dr Ste 400, Bountiful, UT 84010-7676 | 2008-03-27 |
| 1003439373 | Courtney Whidden Page | Physician Assistant | 1551 Renaissance Towne Dr Ste 400, Bountiful, UT 84010-7676 | 2020-05-21 |
| 1609426006 | Whitney S Woodruff | Nurse Practitioner | 1551 Renaissance Towne Dr Ste 400, Bountiful, UT 84010-7676 | 2019-09-17 |
| 1396296216 | Clint J Wooten Md PC | Orthopaedic Surgery | 1551 Renaissance Towne Dr Ste 400, Bountiful, UT 84010-7676 | 2016-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225699192 | Jessyca K Willie | Behavior Technician | 415 S. Medical Drive Suite D101, Bountiful, UT 84010 | 2019-06-21 |
| 1336634344 | Shanna Joy Jaggers | Social Worker | 2333 S 200 E, Bountiful, UT 84010 | 2018-06-22 |
| 1447773171 | Live Life Alarms | Emergency Response System Companies | 640 South 500 West, Bountiful, UT 84010 | 2017-07-25 |
| 1902328842 | Hailey Embley | Behavior Technician | 415 Medical Drive D 101, Bountiful, UT 84010 | 2017-07-12 |
| 1508318031 | Beverly Nielsen | Psychologist | 1001 Lakeview Drive, Bountiful, UT 84010 | 2016-11-01 |
| 1295287720 | Samantha Oslund | Speech-Language Pathologist | 415 Medical Dr Ste B102, Bountiful, UT 84010 | 2016-11-01 |
| 1750748273 | Jeremy Clark Morris | Dentist | 59 W 1600 N, Suite 110, Bountiful, UT 84010 | 2016-01-28 |
| 1629464706 | Shane James | Speech-Language Pathologist | 425 Medical Dr Ste 122, Bountiful, UT 84010 | 2015-04-15 |
| 1891186102 | Kenton Francis | Social Worker | 1355 North Main Street #1, Bountiful, UT 84010 | 2015-02-09 |
| 1205233855 | Modern Dental Professionals - Utah, PC | Dentist | 24 S. 500 West, #a, Bountiful, UT 84010 | 2014-11-25 |
| Find all providers in zip 84010 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063921997 | David Buhler | Physician Assistant | 380 N 200 W Ste 209, Bountiful, UT 84010-7075 | 2017-09-22 |
| 1902265317 | Clarke Lunt | Physician Assistant | 1973 S Davis Blvd, Bountiful, UT 84010-5305 | 2016-02-12 |
| 1265799308 | James Scott Scoville | Physician Assistant | 1551 S. Renaissance Towne Drive, Suite 400, Bountiful, UT 84010 | 2012-04-13 |
| 1477571065 | Todd Dale Lythgoe | Physician Assistant | 1560 Renaissance Towne Dr, Suite 210, Bountiful, UT 84010-7680 | 2006-07-18 |
| 1811947229 | Michael Richard Gaffney | Physician Assistant | 1033 Millstream Way, Bountiful, UT 84010-2119 | 2006-05-10 |
| 1003439373 | Courtney Whidden Page | Physician Assistant | 1551 Renaissance Towne Dr Ste 400, Bountiful, UT 84010-7676 | 2020-05-21 |
| 1407322779 | Mary E Mcmillan | Physician Assistant | 390 N Main St, Bountiful, UT 84010-6046 | 2018-10-15 |
| 1891187894 | Bridger G Butters | Physician Assistant | 185 S 400 E, Ste 100, Bountiful, UT 84010-4801 | 2015-02-27 |
| 1073875126 | David L Badham | Physician Assistant | 557 W 2600 S, Bountiful, UT 84010-7717 | 2012-06-14 |
| 1215211107 | Natalie M Parkin | Physician Assistant | 425 Medical Dr Ste 205, Bountiful, UT 84010-4953 | 2011-10-10 |
| Find all providers in BOUNTIFUL | ||||
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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.