Barbara Lynn Peterson, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

8983 Issued in MN

Practice address

1619 Dayton Ave
Ste 205
Saint Paul, MN 55104-6206

Phone

(651) 645-0478

Fax

(651) 642-2523

NPI assigned

Aug 25, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003809062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 FAIRMOUNT AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052315",
            "telephone_number": "651-699-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 DAYTON AVE",
            "address_2": "STE 205",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046206",
            "telephone_number": "651-645-0478",
            "fax_number": "651-642-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BARBARA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "8983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peterson Dental PA
• Abigail Ellen Peterson, M.D.
• Amanda Flowers Peterson
• Amanda Vancene Peterson, AGACNP
• Barbara Jean Peterson, N.P.
• Bjorn Karl Peterson, M.D.
• Daniel S Peterson, D.C.
• David Donald Peterson, D.C.
• Deborah Anne Peterson
• Elisabeth M Peterson, DDS

• Medical Physician Assistant in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Medical Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.