Paityn Lana Petersen, WHNP-BC

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

15140-33 Issued in WI

Practice address

312 S 7TH St
Delavan, WI 53115-1964

Phone

(262) 728-1849

NPI assigned

Mar 7, 2024

Last updated

Apr 2, 2024By the provider in NPPES

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

Other names 1

• Paityn Lana Ries Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: paityn.petersen.p1@direct.ppwi.nextgenshare.com

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

{
    "created_epoch": "1709769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1477311280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W1571 HUNTERS LN",
            "city": "HELENVILLE",
            "state": "WI",
            "postal_code": "531379773",
            "telephone_number": "262-424-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 S 7TH ST",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531151964",
            "telephone_number": "262-728-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "PAITYN",
        "middle_name": "LANA",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WI",
            "license": "15140-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAITYN",
            "last_name": "RIES",
            "middle_name": "LANA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiffany Dawn Ogg, L.P.N.
• Om Alternative Health Partners, Inc
• Amar Pattani, DDS
• Francine Pease, M.S.
• Alison Person
• Thomas David Petersen, MSCCCSLP
• Olivia Peterson
• Eric Ploeckelman, PTA
• Clifford Robert Poplar, M.D.
• Adam Prince, RPH

• Women's Health Nurse Practitioner in Delavan, WI
• Providers in Delavan, WI by specialty
• Women's Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.