Christinie Peterson, FNP-BC

Individual provider Active NPI Family Nurse Practitioner · Taylor, MI

NPI 1134582828 · NPPES record last updated Jul 16, 2016

Key facts

NPI
1134582828
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
4704275452 (MI)
Practice address
24887 Goddard Rd
Taylor, MI 48180-3930
Phone
(734) 946-5410
NPI assigned
Mar 31, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160602000292 MI Practitioner - Nurse Practitioner 2860782984 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Current
since Oct 1, 2020
Accepting new patients
Vpa PC Current
since Oct 1, 2020
Accepting new patients
M a Haroon, MD, PC Current
since May 15, 2016
Accepting new patients
Vpa PC Current Accepting new patients
Medical Associates, PC Current
since Mar 5, 2020
Accepting new patients
Omega Home Medical Equipment, Inc Past
since May 15, 2016
Accepting new patients

Locations

2205 Jolly Rd
Ste B
Okemos, MI 48864
Phone (517) 347-4085

24887 Goddard Rd
Taylor, MI 48180
Phone (734) 946-0228

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

500 Kirts Blvd
Troy, MI 48084
Phone (214) 824-6000

428 S Grove St
Ypsilanti, MI 48198
Phone (734) 483-1214

Interoperability endpoints

  • Direct secure messaging: cpeterson626423@direct.hfhs.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704275452 MI Yes

Addresses

Primary practice location

24887 Goddard Rd
Taylor, MI 48180-3930

Mailing address

24887 Goddard Rd
Taylor, MI 48180-3930

Other providers in Taylor, MI

All providers in Taylor, MI · Family Nurse Practitioner in Michigan

Sources for this page

Verify at the official NPI Registry.