Kim M Peters, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2012008395 Issued in MO

Practice address

100 Medical Dr
Hannibal, MO 63401-6877

Phone

(573) 231-3116

Fax

(573) 231-3714

NPI assigned

Mar 2, 2012

Last updated

Jul 19, 2024By 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

Nurse Practitioner

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1063786424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 N 64TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623058370",
            "telephone_number": "217-257-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016877",
            "telephone_number": "573-231-3116",
            "fax_number": "573-231-3714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "KIM",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2012008395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Navdeepa Parmar, MD
• Hemal M Patel, D.O.
• Paul Tracy OD
• Allie Pennewell, DNP, CRNA
• Veronica Perkins, LCSW
• Kathy Lynn Pfaffe, LPSW, LPC, LMSW
• Ryan A Pickett, PLPC
• Melinda Pickins
• Fe Maria A Pimentel-Yager, MD
• Christina M Plenge, MSW, LCSW

• Adult Health Nurse Practitioner in Hannibal, MO
• Providers in Hannibal, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.