Active NPI
Nadine Joanne Peterson, LP
- Psychologist
- North Saint Paul, MN
National Provider Identifier
1457340614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP1003
- Practice address
- 2440 N Charles St
#228
North Saint Paul, MN 55109 - Phone
- (651) 307-0282
- NPI assigned
- Oct 19, 2005
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP1003 | MN | Primary |
Addresses
Primary practice location
2440 N Charles St
#228
North Saint Paul, MN 55109
Mailing address
2440 N Charles St
#228
North Saint Paul, MN 55109
Phone (651) 307-0282
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8122539002 | Medicaid | MN |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP1003 | MN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1457340614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2440 N CHARLES ST",
"address_2": "#228",
"city": "NORTH SAINT PAUL",
"state": "MN",
"postal_code": "55109",
"telephone_number": "651-307-0282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2440 N CHARLES ST",
"address_2": "#228",
"city": "NORTH SAINT PAUL",
"state": "MN",
"postal_code": "55109",
"telephone_number": "651-307-0282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "NADINE",
"middle_name": "JOANNE",
"credential": "LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-19",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP1003",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8122539002",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.