PHYLLIS G PETERSON (NPI# 1366703019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366703019 |
Entity Type | Individual |
Full Name | PHYLLIS G PETERSON |
Credential | NP |
Practice Address |
103 Dr. Bowen St. Belle Chasse LA 70037 |
Practice Telephone | 5043923392 |
Practice Fax Number | 5043923303 |
Mailing Telephone | 5043923392 |
Mailing Fax Number | 5043923303 |
Enumeration Date | 2012-05-30 |
Last Update Date | 2014-06-13 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
2065 | LA | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
LA | 2364693 | 05 | |
LA | 2065 | 2065 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346246634 | Phyllis Rose Peterson | Physician Assistant | Ttuhsc Dept of Psychiatry, 3601 4th St., Ms 8103, Lubbock, TX 79430-8103 | 2005-06-22 |
1629157508 | Phyllis Lee Peterson | Physical Therapist | 3112 N Ocoee St, Cleveland, TN 37312 | 2006-11-03 |
Street Address |
103 DR. BOWEN ST. |
City | BELLE CHASSE |
State | LA |
Zip Code | 70037 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689100851 | Cassandra Bell | Counselor | 221 Intrepid Dr, Belle Chase, LA 70037 | 2017-05-10 |
1558818617 | Emily Camp | Counselor | 115 Keating Drive, New Orleans, LA 70037 | 2016-09-07 |
1548650831 | Giambelluca Medical Clinic LLC | Family Medicine | 8732 Highway 23, Belle Chasse, LA 70037 | 2015-01-26 |
1417265224 | Jeffrey Ciro Dimarco | Pharmacist | 8443 Hwy. 23, Belle Chasse, LA 70037 | 2010-09-15 |
1528200342 | Laurene' Andree' Bossier | Speech-Language Pathologist | 162 South Concord Road, Apt. A, Belle Chasse, LA 70037 | 2009-03-25 |
1891979589 | Plaquemines Parish School Board | Local Education Agency (LEA) | 1484 Woodland Highway, Belle Chasse, LA 70037 | 2007-12-18 |
1891989679 | Greater New Orleans Supports & Services Center | Custodial Care Facility | 234 F Edward Hebert Blvd, Bell Chasse, LA 70037 | 2007-09-05 |
1689741639 | Bryan Federico | Physical Therapist | 8397 Highway 23 Ste 101, Belle Chasse, LA 70037 | 2006-11-28 |
1750492898 | Belle Chasse Family Medical Clinic | Family Medicine | 8200 Hwy 23, Belle Chasse, LA 70037 | 2006-08-31 |
1053420208 | James J Young IIi | Dentist | 7772 Highway 23, B, Belle Chasse, LA 70037 | 2006-08-30 |
Find all providers in zip 70037 |
Taxonomy Code | 363LP2300X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Primary Care |
Definition to come... |
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1548870439 | Tamara Dianne Mcadams | Nurse Practitioner | 156 Bobby Johnson Rd, Farmerville, LA 71241-8138 | 2020-08-05 |
1699384099 | Health & Wellness Home Medical Services, LLC | Nurse Practitioner | 211 N 1st St Ste 2, Amite, LA 70422-2466 | 2020-07-31 |
1417565615 | Bobby D Chelette | Nurse Practitioner | 181 Hat Creek Dr, West Monroe, LA 71292-1031 | 2020-07-14 |
1396363438 | Blake Mccullough Williams | Nurse Practitioner | 1017 N Pine St, Deridder, LA 70634-2817 | 2020-07-06 |
1730712605 | Christopher Aaron Sissell | Nurse Practitioner | 1850 Gause Blvd E Ste 103, Slidell, LA 70461-5454 | 2020-02-19 |
1790316610 | Perkins Nurse Practitioner Services | Nurse Practitioner | 9307 Melissa Way, Shreveport, LA 71115-2527 | 2020-01-29 |
1598305260 | Hollie Cavel Touchet | Nurse Practitioner | 116 Chicory Ln, Lafayette, LA 70506-9210 | 2020-01-10 |
1780228312 | Sharel Randolph Williams | Nurse Practitioner | 614 Harmony St, New Orleans, LA 70115-1108 | 2019-11-06 |
Find all providers with the same taxonomy |
City | BELLE CHASSE |
Zip Code | 70037 |
Please comment or provide details below to improve the information on PHYLLIS G PETERSON.
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.