PHYLLIS G PETERSON


Address: 103 Dr. Bowen St., Belle Chasse, LA 70037
Phone: 5043923392

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
LA 2364693 05
LA 2065 2065 01

Other Providers PHYLLIS PETERSON

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

Office Location

Street Address 103 DR. BOWEN ST.
City BELLE CHASSE
State LA
Zip Code 70037

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

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Competitor

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City BELLE CHASSE
Zip Code 70037

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Dataset Information

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.

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