AMANDA MICHELLE PETERSON (NPI# 1457805020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457805020 |
| Entity Type | Individual |
| Full Name | AMANDA MICHELLE PETERSON |
| Other Name | AMANDA MICHELLE STUTSMAN |
| Credential | PA-C |
| Practice Address |
11850 Blackfoot St Nw Ste 300 Coon Rapids MN 55433-2578 |
| Practice Telephone | 7632369000 |
| Practice Fax Number | 7632369010 |
| Mailing Telephone | 7632369000 |
| Mailing Fax Number | 7632369010 |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2016-08-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629559992 | Amanda Ann Peterson | Dietitian, Registered | 6405 France Ave S Ste 480, Edina, MN 55435-2172 | 2018-08-24 |
| 1891230710 | Amanda Kay Peterson | Chiropractor | 421 Front St S, Barnesville, MN 56514-3656 | 2017-01-01 |
| 1528420486 | Amanda Peterson | Counselor | 9580 W Reno Ave, Unit 111, Las Vegas, NV 89148-1710 | 2016-03-22 |
| 1427467828 | Amanda Jean Peterson | Physical Therapist | 1045 Broadway Park Ste 107, Homewood, AL 35209-6256 | 2014-08-11 |
| 1528328275 | Amanda Peterson | Dietitian, Registered | 25 Courtenay Drive, Suite 7100a Msc 290, Medical University of South Carolina, Charleston, SC 29425 | 2012-05-29 |
| 1922605641 | Amanda Peterson | Physical Therapist | 140 S Main St, Saint Albans, VT 05478-1895 | 2020-10-06 |
| 1245851575 | Amanda Lynn Peterson | Pharmacist | 2001 Court Ave, Chariton, IA 50049-1955 | 2020-04-28 |
| 1396371100 | Amanda Mae Peterson | Advanced Practice Midwife | 3601 The Vanderbilt Clinic, Nashville, TN 37232-0001 | 2020-03-13 |
| 1982235354 | Amanda Peterson | Behavior Technician | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5326 | 2020-02-04 |
| 1659939320 | Amanda Lee Peterson | Behavior Technician | 245 1st St, Cambridge, MA 02142-1200 | 2019-05-29 |
| Street Address |
11850 BLACKFOOT ST NW STE 300 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-2578 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255392353 | Robin R Uithoven | Nurse Practitioner | 11850 Blackfoot St Nw, Suite 100, Coon Rapids, MN 55433-2578 | 2006-03-29 |
| 1346768884 | Drew Alexander Holm | Physician Assistant | 11850 Blackfoot St Nw, Coon Rapids, MN 55433-2578 | 2017-09-05 |
| 1912458571 | Denise Rae Jones | Genetic Counselor, MS | 11850 Blackfoot St Nw, Suite 130, Coon Rapids, MN 55433-2578 | 2016-10-19 |
| 1356895759 | Hannah Wheaton | Physician Assistant | 11850 Blackfoot St Nw, Ste. 300, Coon Rapids, MN 55433-2578 | 2016-08-15 |
| 1861945693 | Maureen Carberry | Physician Assistant | 11850 Blackfoot St Nw, #300, Coon Rapids, MN 55433-2578 | 2016-07-28 |
| 1104163369 | Krista Marie Skoglund | Physician Assistant | 11850 Blackfoot St Nw, Suite 490, Coon Rapids, MN 55433-2578 | 2013-01-08 |
| 1255641791 | Derek Paul Doty | Chiropractor | 11850 Blackfoot St Nw, Ste. 405, Coon Rapids, MN 55433-2578 | 2010-10-18 |
| 1376856500 | Niloo Shanya Krueger | Surgery | 11850 Blackfoot St Nw, Coon Rapids, MN 55433-2578 | 2010-07-16 |
| 1699001180 | Rachel Lynn Stevens | Physician Assistant | 11850 Blackfoot St Nw, Suite 490, Coon Rapids, MN 55433-2578 | 2009-10-19 |
| 1912133752 | Lisa Hamilton | Surgery | 11850 Blackfoot St Nw, Suite 300, Coon Rapids, MN 55433-2578 | 2009-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871079004 | Kayla Marie Heyn | Physician Assistant | 11850 Blackfoot St Nw Ste 490, Coon Rapids, MN 55433-2773 | 2018-07-11 |
| 1023524204 | Chelsie Nicole Horner | Physician Assistant | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2017-12-24 |
| 1104163369 | Krista Marie Skoglund | Physician Assistant | 11850 Blackfoot St Nw, Suite 490, Coon Rapids, MN 55433-2578 | 2013-01-08 |
| 1083641195 | Andrew R Schock | Physician Assistant | 11850 Blackfoot St Nw, Suite 490, Coon Rapids, MN 55433-2578 | 2006-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194120204 | Nathan C Clapper | Physician Assistant | 3580 Arcade St Ste 100, Vadnais Heights, MN 55127-7135 | 2014-10-31 |
| 1003180555 | Elizabeth K Saterenzoller | Physician Assistant | 1015 Marsh Street, Mankato, MN 56002-8673 | 2012-03-01 |
| 1477824472 | Andrea Jo Pitzl | Physician Assistant | 3208 36th Ave Ne, St Anthony, MN 55418-1713 | 2012-01-23 |
| 1447560693 | Jeanine Marie Edstrom | Physician Assistant | 1185 Town Centre Dr Ste 200, Eagan, MN 55123-1343 | 2010-10-20 |
| 1841504792 | Michelle R Aumock | Physician Assistant | 8100 W 78th Street, Ste 230, Edina, MN 55439 | 2010-08-03 |
| 1194042390 | Gerald Frederick Anderson | Physician Assistant | 4060 Haines Rd, #104, Duluth, MN 55811-1746 | 2010-04-27 |
| 1558683904 | Oswaldo Serge | Physician Assistant | 4036 3rd St Nw, Rochester, MN 55901-7564 | 2010-02-25 |
| 1417288945 | Amanda Kay Johnson | Physician Assistant | 201 W Center St Ei-01 Surgical Assistant, Rochester, MN 55902-3003 | 2010-01-22 |
| 1790922755 | Jenelle Cecilia Rock | Physician Assistant | 1950 Northwestern Ave S, Suite 102, Stillwater, MN 55082-7590 | 2009-01-13 |
| 1174775514 | Nathan J Nistler | Physician Assistant | 3580 Arcade Stq, Vadnais Heights, MN 55127-7135 | 2008-10-16 |
| Find all providers with the same taxonomy | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
Please comment or provide details below to improve the information on AMANDA MICHELLE 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.