Angela T Petkoff, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APN.0994018-NP Issued in CO

Practice address

10900 W 44TH Ave Unit 200
Wheat Ridge, CO 80033-2742

Phone

(303) 993-1330

Fax

(303) 957-5757

NPI assigned

Jul 17, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1154807667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 W 44TH AVE",
            "address_2": "UNIT 200",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332742",
            "telephone_number": "720-923-1239",
            "fax_number": "303-284-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 W 44TH AVE UNIT 200",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332742",
            "telephone_number": "303-993-1330",
            "fax_number": "303-957-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETKOFF",
        "first_name": "ANGELA",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-17",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "APN.0994018-NP",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "APN.0994018-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0994018-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO DEPARTMENT OF REGULATORY AGENCIES",
            "identifier": "APN.0994018-NP",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Peterson
• Katherine R Peterson, N.D.
• Kirby Peterson
• Lauren Kathleen Peterson, D.M.D.
• Rae-Jean Michelle Peterson, RN
• Vickie Lynn Petric, PTA
• Melissa Marie Petrovic
• Hanna Francis Pettersen
• Angela Pezzella, LPCC
• Felany Phan

• Nurse Practitioner in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.