Active NPI
Robin Elaine Petersen, RN FNP
- Nurse Practitioner
- Grass Valley, CA
National Provider Identifier
1447221213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 12010
- Practice address
- 150 Catherine LN
# D
Grass Valley, CA 95945-5719 - Phone
- (530) 477-8358
- Fax
- (530) 477-2015
- NPI assigned
- Jan 30, 2006
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 12010 | CA | Primary |
Addresses
Primary practice location
150 Catherine LN
# D
Grass Valley, CA 95945-5719
Mailing address
1010 Hurley Way
Suite 500
Sacramento, CA 95825-3215
Phone (916) 564-3040
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
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12010 | CA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422662400000",
"number": "1447221213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 HURLEY WAY",
"address_2": "SUITE 500",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958253215",
"telephone_number": "916-564-3040",
"fax_number": "916-564-3065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 CATHERINE LN",
"address_2": "# D",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959455719",
"telephone_number": "530-477-8358",
"fax_number": "530-477-2015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "ROBIN",
"middle_name": "ELAINE",
"name_prefix": "Mrs.",
"credential": "RN FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-30",
"last_updated": "2015-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "12010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grass Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.