Nicole Marie Petersen, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

2003023575 Issued in MO

Practice address

8200 N Lindbergh Blvd
Schnucks Pharmacy
Florissant, MO 63031-7107

Phone

(314) 921-7345

Fax

(314) 921-7346

NPI assigned

Jun 30, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1144227448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 ALAMO AVE",
            "address_2": "APT 1E",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631053129",
            "telephone_number": "314-446-8555",
            "fax_number": "314-446-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 N LINDBERGH BLVD",
            "address_2": "SCHNUCKS PHARMACY",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630317107",
            "telephone_number": "314-921-7345",
            "fax_number": "314-921-7346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2003023575",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Golden Peters, PHARM.D
• Todd J Petersen, PA-C
• Allison Elizabeth Pettibone, MSW, LMSW
• Julie Pettit, PHARM D
• Kertonnia Petty-Miliken
• Lyra Rivera Phan, PT

• Pharmacist in Florissant, MO
• Providers in Florissant, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.