Active NPI
Stephanie Marie Peterson, RN, BSN
- School Registered Nurse
- Green Bay, WI
National Provider Identifier
1134057904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- 150144-30
- Practice address
- 1567 Deckner Ave
Green Bay, WI 54302-2617 - Phone
- (920) 272-7443
- NPI assigned
- May 12, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | 150144-30 | WI | Primary |
Addresses
Primary practice location
1567 Deckner Ave
Green Bay, WI 54302-2617
Mailing address
1567 Deckner Ave
Green Bay, WI 54302-2617
Phone (920) 272-7443
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150144-30 | WI | MD | School Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1778544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778544000000",
"number": "1134057904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1567 DECKNER AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543022617",
"telephone_number": "920-272-7443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1567 DECKNER AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543022617",
"telephone_number": "920-272-7443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "STEPHANIE",
"middle_name": "MARIE",
"credential": "RN, BSN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-05-12",
"last_updated": "2026-05-12",
"certification_date": "2026-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "WI",
"license": "150144-30",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.