Active NPI
Natalie Petersen
- Dental Hygienist
- Grand Island, NE
National Provider Identifier
1417518424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2891
- Practice address
- 2116 W Faidley Ave Ste 2100
Grand Island, NE 68803-4602 - Phone
- (308) 382-4297
- NPI assigned
- Jun 21, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2891 | NE | Primary |
Addresses
Primary practice location
2116 W Faidley Ave Ste 2100
Grand Island, NE 68803-4602
Mailing address
2116 W Faidley Ave Ste 2100
Grand Island, NE 68803-4602
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2891 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741219200000",
"number": "1417518424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2116 W FAIDLEY AVE STE 2100",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688034602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2116 W FAIDLEY AVE STE 2100",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688034602",
"telephone_number": "308-382-4297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "NATALIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-21",
"last_updated": "2025-03-06",
"certification_date": "2025-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NE",
"license": "2891",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Island, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.