Rachelle Petersen, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

111943 Issued in NE

Practice address

10707 Pacific St
Suite 101
Omaha, NE 68114-4762

Phone

(402) 397-7989

Fax

(402) 397-8703

NPI assigned

Aug 5, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1346794559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10717 VIRGINIA PLZ STE 121",
            "city": "LA VISTA",
            "state": "NE",
            "postal_code": "681284229",
            "telephone_number": "402-779-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10707 PACIFIC ST",
            "address_2": "SUITE 101",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144762",
            "telephone_number": "402-397-7989",
            "fax_number": "402-397-8703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "RACHELLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-05",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "111943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew D. Petersen, S.T.
• Melissa Petersen
• Mickaelle Petersen, MSW, LMHP
• Molly Petersen, APRN
• Nikki Petersen
• Samuel Petersen
• Sarah C Petersen
• Scott Petersen, ED.S.
• Vera Lynn Petersen, MA, PLMHP
• Whitney J Petersen, APRN-NP

• Nurse Practitioner in Omaha, NE
• Providers in Omaha, NE by specialty
• Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.