AMANDA PETERSEN (NPI# 1689163222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689163222 |
| Entity Type | Individual |
| Full Name | AMANDA PETERSEN |
| Credential | FNP-BC, RN |
| Practice Address |
775 Pole Line Rd W Ste 113 Twin Falls ID 83301-5819 |
| Practice Telephone | 2088148292 |
| Mailing Telephone | 2088148292 |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-05-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
58323 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881239499 | Amanda Petersen | Nurse Practitioner | Utmb Health--department of Surgery 301 University Blvd, 6.146 John Sealy Annex, Galveston, TX 77555-0527 | 2019-11-07 |
| 1487908547 | Amanda Petersen | Health Educator | 103 E Macarthur Ave, Bloomington, IL 61701-5234 | 2012-10-28 |
| 1063983724 | Amanda Joan Petersen | Nurse Anesthetist, Certified Registered | Duluth Clinic, 400 East Third Street, Duluth, MN 55805-1951 | 2018-12-06 |
| 1154760627 | Amanda Ruth Petersen | Counselor | 2200 4th St, Baker City, OR 97814-2615 | 2013-06-18 |
| 1962746818 | Amanda Lee Petersen | Occupational Therapist | 90 Howard Dr, Shelbyville, KY 40065-8138 | 2012-11-15 |
| 1528391372 | Amanda D Petersen | Physician Assistant | 4804 W Clearwater Ave, Kadlec Clinic Urgent Care, Kennewick, WA 99336 | 2009-09-11 |
| 1215186192 | Amanda Ward Petersen | Physical Therapy Assistant | 1610 N Queen St, Kinston, NC 28501-2947 | 2008-09-16 |
| Street Address |
775 POLE LINE RD W STE 113 |
| City | TWIN FALLS |
| State | ID |
| Zip Code | 83301-5819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
| 1780146316 | Frontier Pediatric Partners, Pllc | Pediatrics | 1502 Locust Street N #700, Twin Falls, ID 83301 | 2019-04-02 |
| 1972073377 | Wood River Acupuncture | Acupuncturist | 1625 Addison Ave East, Twin Falls, ID 83301 | 2018-11-28 |
| 1235629874 | Lonnie Paul | Counselor | 1092 Eastland Dr N Ste A, Twin Falls, ID 83301 | 2018-05-17 |
| 1679060966 | Christina Jirapha Thongdee | Social Worker | 625 Poleline Road West, Suite 2a, Twin Falls, ID 83301 | 2018-04-23 |
| 1437658499 | Tyrel Kevin Ward | Chiropractor | 2167 Village Park Ave., Suite 100, Twin Falls, ID 83301 | 2018-02-06 |
| 1851836381 | Tanabell Health Services, Inc | Skilled Nursing Facility | 1134 Cheney Drive West, Twin Falls, ID 83301 | 2016-12-19 |
| 1578005195 | Matthew Carter | Physical Therapist | 1053 Eastland Drive, Twin Falls, ID 83301 | 2016-11-14 |
| 1790227783 | Murvat Usmanova | Nurse Practitioner | 775 Pole Line Road W, Suite 203, Twin Falls, ID 83301 | 2016-11-08 |
| 1265894687 | Shawna Fultz | Social Worker | 1201 Fall Ave East Suite C, Twin Falls, ID 83301 | 2016-03-24 |
| Find all providers in zip 83301 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659979516 | Jennifer Anne Gardner | Nurse Practitioner | 1385 Park View Dr Ste 101, Twin Falls, ID 83301-4390 | 2020-10-13 |
| 1518515949 | Carisa Dawn Elliott | Nurse Practitioner | 370 North Haven Drive, Twin Falls, ID 83301-6178 | 2019-08-28 |
| 1760990378 | Robin Lin Hall | Nurse Practitioner | 714 N College Rd Ste B, Twin Falls, ID 83301-5812 | 2018-01-17 |
| 1720513682 | Jennifer Marie Benally | Nurse Practitioner | 418 Madison St, Twin Falls, ID 83301-4721 | 2017-04-27 |
| 1366982621 | Stacie Mccomas | Nurse Practitioner | 476 Cheney Dr W, Suite 160, Twin Falls, ID 83301-3741 | 2017-03-06 |
| 1790227783 | Murvat Usmanova | Nurse Practitioner | 775 Pole Line Road W, Suite 203, Twin Falls, ID 83301 | 2016-11-08 |
| 1063872489 | Blue Lakes Medicine Pa | Nurse Practitioner | 1122 Eastland Dr N, Ste 2, Twin Falls, ID 83301-8444 | 2016-02-26 |
| 1811354640 | Amra Suljevic | Nurse Practitioner | 775 Pole Line Rd W Ste 312, Twin Falls, ID 83301-5823 | 2016-01-25 |
| 1497120349 | Charles Blaise Larson | Nurse Practitioner | 730 N College Rd Ste B, Twin Falls, ID 83301-3382 | 2015-12-03 |
| 1699144691 | Maricruz Davis | Nurse Practitioner | 850 Cambron Ave, Twin Falls, ID 83301-4789 | 2015-09-20 |
| Find all providers in TWIN FALLS | ||||
| City | TWIN FALLS |
| Zip Code | 83301 |
Please comment or provide details below to improve the information on AMANDA PETERSEN.
| 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.