Paula Kay Petersburg, R.PH

Primary specialty

PharmacistTaxonomy code 183500000X

License

3010 Issued in WY

Practice address

1898 Fort Rd
Sheridan, WY 82801-8320

Phone

(307) 672-3473

NPI assigned

May 7, 2007

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043422389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 UPPER PRAIRIE DOG RD",
            "city": "BANNER",
            "state": "WY",
            "postal_code": "828329712",
            "telephone_number": "307-683-3248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1898 FORT RD",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828018320",
            "telephone_number": "307-672-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSBURG",
        "first_name": "PAULA",
        "middle_name": "KAY",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WY",
            "license": "3010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Sheridan, WY
• Pharmacist in Wyoming

• 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.