KATIE MARIE PETERSON (NPI# 1508265331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508265331 |
| Entity Type | Individual |
| Full Name | KATIE MARIE PETERSON |
| Credential | AGNP |
| Practice Address |
3931 Louisiana Ave S Suite E202 Saint Louis Park MN 55426-5000 |
| Mailing Address |
2103 Doswell Ave Saint Paul MN 55108-1731 |
| Practice Telephone | 9529939184 |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2014-08-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
AG0614152 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780121152 | Katie Marie Peterson | Dietitian, Registered | 1161 Chestnut Cove Rd, Sylva, NC 28779-7246 | 2017-01-24 |
| 1821399338 | Katie J Peterson | Physical Therapist | 1443 Ashbury Ln W, Roselle, IL 60172-4703 | 2010-11-15 |
| 1477886323 | Katie Peterson | Physician Assistant | 17521 93rd Pl N, Maple Grove, MN 55311-4437 | 2009-09-10 |
| 1528119906 | Katie Lynne Peterson | Specialist/Technologist | 3151 N Windsong Dr, Prescott Valley, AZ 86314-2240 | 2007-01-14 |
| 1477076073 | Katie Peterson | Nurse Practitioner | 1600 N Missouri Ave, Marceline, MO 64658-1012 | 2017-07-25 |
| 1235589672 | Katie Peterson | Physical Therapist | 1703 W Stones Crossing Rd Ste 120, Greenwood, IN 46143 | 2016-06-16 |
| 1881065647 | Katie Van Hoof Peterson | Specialist/Technologist, Other | 3311 Prescott Rd Ste 202, Alexandria, LA 71301-3983 | 2015-10-19 |
| 1295176063 | Katie E Peterson | Advanced Practice Midwife | 5 Tampa General Circle, Suite 240, Tampa, FL 33606 | 2013-07-09 |
| 1033471263 | Katie Dawn Peterson | Dentist | 920 N Main St, Mountain Grove, MO 65711-1315 | 2012-06-13 |
| 1154680569 | Katie Beth Peterson | Developmental Therapist | 321 Fortune Blvd, Milford, MA 01757-1750 | 2012-05-07 |
| Street Address |
3931 LOUISIANA AVE S SUITE E202 |
| City | SAINT LOUIS PARK |
| State | MN |
| Zip Code | 55426-5000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922596782 | Elizabeth Thingvold | Dietitian, Registered | 3931 Louisiana Ave S, Saint Louis Park, MN 55426 | 2018-04-27 |
| 1235493677 | Adina L Peck | Nurse Practitioner | 3931 Louisiana Ave S, Saint Louis Park, MN 55426-4375 | 2012-06-29 |
| 1083923494 | Julie Ann Such | Nurse Practitioner | 3931 Louisiana Ave S, Ste E400, Saint Louis Park, MN 55426-5000 | 2010-10-03 |
| 1558597021 | Sharon L Zehender | Occupational Therapist | 3931 Louisiana Ave S, Saint Louis Park, MN 55426-5000 | 2009-06-10 |
| 1821278953 | Jessica Sanchez-alfaro | Family Medicine | 3931 Louisiana Ave S, Saint Louis Park, MN 55426-5000 | 2007-11-06 |
| 1073549986 | Rachel E. Lerner | Internal Medicine | 3931 Louisiana Ave S, Ste E400, Saint Louis Park, MN 55426-5000 | 2006-06-23 |
| 1316923055 | Lori J. Fewer | Registered Nurse | 3931 Louisiana Ave S, Ste E400, Saint Louis Park, MN 55426-5000 | 2005-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821657545 | Big Brain Concussion Recovery & Chiropractic Pa | Chiropractor | 3313 Republic Ave., St. Louis Park, MN 55426 | 2019-06-06 |
| 1912485095 | Daniel Raies | Optometrist | 8900 Minnesota 7, St Louis Park, MN 55426 | 2018-08-01 |
| 1649756040 | Wayside House, Inc. | Clinic/Center | 1349 Jersey Ave S, St. Louis Park, MN 55426 | 2018-07-18 |
| 1104302884 | Superior Caregivers, LLC | In Home Supportive Care | 1319 Lancaster Ave., St. Louis Park, MN 55426 | 2018-07-16 |
| 1396234266 | Caitlin Kwiatkowski | Behavior Technician | 7010 Mn-7, St.louis Park, MN 55426 | 2018-05-07 |
| 1497244313 | Kelly Ann Clancey | Behavior Technician | 7010 Highway 2, Saint Louis Park, MN 55426 | 2018-05-07 |
| 1770072696 | Ashleigh Hakala | Behavior Technician | 7010 Highway 7 St. Louis Park Mn 55426, St. Louis Park, MN 55426 | 2018-05-07 |
| 1689181521 | Glenda Miles | Registered Nurse | 7316 Cedar Lake Road, Apt 8, St Louis Park, MN 55426 | 2017-12-31 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1447775549 | Belinda Sue Bliss | Marriage & Family Therapist | 3301 Decatur Lane, Saint Louis Park, MN 55426 | 2017-08-09 |
| Find all providers in zip 55426 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255647798 | Angela Vanderheyden | Nurse Practitioner | 3850 Park Nicollet Blvd, Senior Services, Saint Louis Park, MN 55416-2527 | 2010-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619587193 | Sadiya Abdirahman Esse | Nurse Practitioner | 1690 Silver Lake Rd Nw, New Brighton, MN 55112-1788 | 2020-08-09 |
| 1881226512 | Abby Marie Zenner | Nurse Practitioner | 1771 Countryside Dr, Shakopee, MN 55379-4451 | 2020-02-11 |
| 1174019038 | Adedayo Temitope Dosumu | Nurse Practitioner | 816 50th Ave Nw, Rochester, MN 55901-6554 | 2018-07-03 |
| 1407223159 | Carla Sue Christenson | Nurse Practitioner | 3400 W. 66th St, Edina, MN 55435 | 2015-08-28 |
| 1538573449 | Rebecca Anne Lenz | Nurse Practitioner | 1172 Randolph Ave Apt 8, Saint Paul, MN 55105-2987 | 2014-06-18 |
| 1083027536 | Mueni C Mualuko | Nurse Practitioner | 2220 Riverside Ave # Ms 26602g, Geriatrics Department Ms 26602g/ 2220 Riverside Ave, Minneapolis, MN 55454-1321 | 2014-06-03 |
| 1659623999 | Joy Laansma | Nurse Practitioner | 3366 Oakdale Avenue North, Suite 551, Robbinsdale, MN 55422-2948 | 2012-10-10 |
| 1720337694 | Zhonghua Xie | Nurse Practitioner | 1202 5th Grant Blvd W, Wabasha, MN 55981-1115 | 2012-09-06 |
| 1487937892 | Jonathan Deforest Olson | Nurse Practitioner | 30 W 22nd St, #204, Minneapolis, MN 55404-2428 | 2011-09-21 |
| 1548577224 | Lorene Ann Gray | Nurse Practitioner | 6465 W Shadow Lake Dr, Lino Lakes, MN 55014-1982 | 2010-09-02 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS PARK |
| Zip Code | 55426 |
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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.