Traci Lynn Peterson, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5696047-4405 Issued in UT

Practice address

3225 W Gordon Ave
#1
Layton, UT 84041-6508

Phone

(801) 773-7232

Fax

(801) 927-4218

NPI assigned

Jan 15, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Traci Lynn Ostler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1285965293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 W GORDON AVE",
            "address_2": "#1",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840416508",
            "telephone_number": "801-773-7232",
            "fax_number": "801-927-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 W GORDON AVE",
            "address_2": "#1",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840416508",
            "telephone_number": "801-773-7232",
            "fax_number": "801-927-4218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "TRACI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-15",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "5696047-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "OSTLER",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joy Shondell Peterson
• Katharine Peterson
• Kylie Peterson, RDN, CD, CDE
• Maddison J Peterson
• Quinn Peterson
• Shaylynn Pettigrew
• Anna Pettipaw
• Lisa Pettus
• Hinauri Pfeiffer
• Elliott Phares

• Nurse Practitioner in Layton, UT
• Providers in Layton, UT by specialty
• Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.