Active NPI
Kaia Petersen, ARNP
- Women's Health Nurse Practitioner
- Muscatine, IA
National Provider Identifier
1467590398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- F-067497
- Practice address
- 1609 Cedar St
Muscatine, IA 52761-3426 - Phone
- (563) 263-0122
- Fax
- (563) 263-0520
- NPI assigned
- Feb 2, 2007
- 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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | F-067497 | IA | Primary |
Addresses
Primary practice location
1609 Cedar St
Muscatine, IA 52761-3426
Mailing address
1019 Sunrise Cir
Muscatine, IA 52761-3628
Phone (563) 263-1326
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22599 | Other | IA | BLUE CROSS BLUE SHEILD |
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 |
|---|---|---|---|
| F-067497 | IA | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509926400000",
"number": "1467590398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1019 SUNRISE CIR",
"city": "MUSCATINE",
"state": "IA",
"postal_code": "527613628",
"telephone_number": "563-263-1326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1609 CEDAR ST",
"city": "MUSCATINE",
"state": "IA",
"postal_code": "527613426",
"telephone_number": "563-263-0122",
"fax_number": "563-263-0520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "KAIA",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-02",
"last_updated": "2017-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "IA",
"license": "F-067497",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHEILD",
"identifier": "22599",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muscatine, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.