REBECCA ANN PETERSON (NPI# 1679934012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679934012 |
| Entity Type | Individual |
| Full Name | REBECCA ANN PETERSON |
| Credential | CNP |
| Practice Address |
4325 Grand Ave Duluth MN 55807 |
| Mailing Address |
3600 Tower Ave Credentialing Department Superior WI 54880-5337 |
| Practice Telephone | 2187221497 |
| Practice Fax Number | 7153955388 |
| Mailing Telephone | 7153955361 |
| Mailing Fax Number | 7153955388 |
| Enumeration Date | 2016-03-13 |
| Last Update Date | 2018-06-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
6896-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP 4442 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | CNP 4442 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3600 Tower Ave, Superior, WI 548805337 | 7153921955 | 7153955388 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386251114 | Rebecca S Peterson | Community Health Worker | 5601 Loch Raven Blvd # G4, Baltimore, MD 21239-2945 | 2020-09-25 |
| 1497377055 | Rebecca Peterson | Licensed Practical Nurse | 297 Mountain View Est, Caryville, TN 37714-3539 | 2020-05-17 |
| 1881818185 | Rebecca Karen Peterson | Psychologist | 13949 Ventura Blvd Ste 210, Sherman Oaks, CA 91423-3570 | 2007-04-11 |
| 1962424044 | Rebecca Jane Peterson | Psychologist | 3309 Duke St, Alexandria, VA 22314-4522 | 2006-07-24 |
| 1225662695 | Rebecca D Peterson | Hospitalist | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2020-02-25 |
| 1205474491 | Rebecca A Peterson | Behavior Technician | 27777 Inkster Rd, Farmington Hills, MI 48334-5326 | 2019-12-18 |
| 1336663467 | Rebecca Peterson | Speech-Language Pathologist | 4600 Lockhill Selma Rd, San Antonio, TX 78249-2185 | 2017-07-31 |
| 1003364829 | Rebecca Peterson | Counselor | 5548 Myrtle Ave, Freeland, WA 98249-8776 | 2016-09-21 |
| 1033664800 | Rebecca Peterson | Speech-Language Pathologist | 4121 Pennsylvania Ave, Dubuque, IA 52002-2628 | 2016-08-22 |
| 1043689177 | Rebecca Peterson | Counselor | 840 E Plum St, Moses Lake, WA 98837-1874 | 2015-09-18 |
| Street Address |
4325 GRAND AVE |
| City | DULUTH |
| State | MN |
| Zip Code | 55807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861484875 | Barbara G Hemenway | Family Medicine | 4325 Grand Ave, Duluth, MN 55807-2730 | 2005-08-16 |
| 1457984783 | Kellie Lynn Murphy | Dental Hygienist | 4325 Grand Ave, Duluth, MN 55807-2730 | 2020-02-14 |
| 1417598079 | Brittany Morgan Hamm | Nurse Practitioner | 4325 Grand Ave, Duluth, MN 55807-2730 | 2019-10-04 |
| 1962997023 | Yin Cao | Dentist | 4325 Grand Ave, Duluth, MN 55807-2730 | 2018-06-29 |
| 1609367895 | Susan Marie Johnson | Licensed Practical Nurse | 4325 Grand Ave, Duluth, MN 55807-2730 | 2018-05-23 |
| 1467993774 | Kristie Hills | Counselor | 4325 Grand Ave, Duluth, MN 55807-2730 | 2017-03-20 |
| 1124569041 | Nicole Shockley | Nurse Practitioner | 4325 Grand Ave, Duluth, MN 55807-2730 | 2017-03-10 |
| 1457714560 | Alecia Radtke | Licensed Practical Nurse | 4325 Grand Ave, Duluth, MN 55807-2730 | 2016-04-05 |
| 1386008449 | Amber Tibbetts | Licensed Practical Nurse | 4325 Grand Ave, Duluth, MN 55807-2730 | 2016-04-05 |
| 1467813964 | Lisa Ann Robertson | Dental Hygienist | 4325 Grand Ave, Duluth, MN 55807-2730 | 2016-03-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568918126 | Jaime Lynn Mallory | Counselor | 4000 W 9th St., Duluth, MN 55807 | 2016-09-01 |
| 1568817138 | Fathers Rise Together | Community/Behavioral Health | 319 N 22nd Ave West, Duluth, MN 55807 | 2016-05-02 |
| 1558660357 | Melissa June Huray | Counselor | 326 North Central Avenue, Duluth, MN 55807 | 2011-03-18 |
| 1376757682 | Chiropractic Health Center P A | Chiropractor | 215 North Central Ave, Duluth, MN 55807 | 2007-05-09 |
| 1639235914 | Mark Andrew Nelson Albee | Social Worker | 4214 Grand Avenue, Duluth Clinic-west, Duluth, MN 55807 | 2006-12-29 |
| 1851457758 | Northwood Children's Services, Inc. | Counselor | 4000 W 9th St, Duluth, MN 55807 | 2006-12-28 |
| 1326134529 | Jane Patricia Rudd | Family Medicine | 4212 Grand Ave, Duluth, MN 55807 | 2006-10-05 |
| 1548290257 | Kirsten I Bich | Family Medicine | 4212 Grand Ave, Essentia Health West Duluth Clinic, Duluth, MN 55807 | 2006-07-05 |
| 1033140660 | Wendell R Bonner | Family Medicine | 4212 Grand Ave, Duluth, MN 55807 | 2006-07-05 |
| 1225525645 | Mark J Engebretson | Social Worker | 5814 Elinor St, Duluth, MN 55807-1215 | 2018-04-20 |
| Find all providers in zip 55807 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033625 | Ashley Thomas | Nurse Practitioner | 3750 Venture Dr Ste E4, Duluth, GA 30096-1863 | 2020-11-03 |
| 1659978930 | Sarah Jean Mudge | Nurse Practitioner | 350 Harbor Dr, Duluth, MN 55802-2600 | 2020-10-08 |
| 1174141873 | Akiysha Collins Caine | Nurse Practitioner | 2200 Satellite Blvd Apt 117, Duluth, GA 30097-4002 | 2020-07-09 |
| 1437608684 | Salimah Chagani | Nurse Practitioner | 4855 River Green Pkwy #700, Duluth, GA 30096 | 2016-09-29 |
| 1316495773 | Lifeline Primary Care | Nurse Practitioner | 4855 River Green Pkwy Ste 700, Duluth, GA 30096-8337 | 2016-09-14 |
| 1619329661 | Stephanie Bridges | Nurse Practitioner | 3575 Koger Blvd, Ste 116, Duluth, GA 30096-7559 | 2016-07-01 |
| 1215336664 | Rachel Marie Swor | Nurse Practitioner | 1000 E 1st St Ste 204, Duluth, MN 55805-2297 | 2014-08-21 |
| 1669811410 | Laura Elizabeth Lashley | Nurse Practitioner | 3505 Duluth Park Ln Bldg 4, Duluth, GA 30096-3201 | 2013-06-14 |
| 1851638423 | Candace Jacobs Ginsberg | Nurse Practitioner | 130 N 60th Ave E, Duluth, MN 55804-2549 | 2013-01-15 |
| 1710275128 | Megan Jennie Baertsch | Nurse Practitioner | 1420 London Rd Ste 100, Duluth, MN 55805-2437 | 2011-07-19 |
| Find all providers in DULUTH | ||||
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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.