Individual provider Active NPI

Hannah Kristina Peterson, BSN, RN, CWON

  • Ostomy Care Registered Nurse
  • Missoula, MT
National Provider Identifier
1477369577
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ostomy Care Registered NurseTaxonomy code 163WX1500X
License
NUR-RN-LIC-198415 Issued in MT
Practice address
2835 Fort Missoula Rd Ste 101
Missoula, MT 59804-7424
Phone
(406) 327-4347
NPI assigned
Dec 4, 2024
Last updated
Dec 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Enterostomal Therapy Registered Nurse 163WE0900X NUR-RN-LIC-198415 MT
Ambulatory Care Registered Nurse 163WP2201X NUR-RN-LIC-198415 MT
Wound Care Registered Nurse 163WW0000X NUR-RN-LIC-198415 MT
Ostomy Care Registered Nurse 163WX1500X NUR-RN-LIC-198415 MT Primary

Addresses

Primary practice location

2835 Fort Missoula Rd Ste 101
Missoula, MT 59804-7424

Mailing address

2835 Fort Missoula Rd Ste 101
Missoula, MT 59804-7424
Phone (406) 327-4347

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
NUR-RN-LIC-198415MTMDAmbulatory Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1477369577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 FORT MISSOULA RD STE 101",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047424",
            "telephone_number": "406-327-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 FORT MISSOULA RD STE 101",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047424",
            "telephone_number": "406-327-4347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "HANNAH",
        "middle_name": "KRISTINA",
        "credential": "BSN, RN, CWON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0900X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Enterostomal Therapy",
            "state": "MT",
            "license": "NUR-RN-LIC-198415",
            "primary": false
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "MT",
            "license": "NUR-RN-LIC-198415",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "MT",
            "license": "NUR-RN-LIC-198415",
            "primary": false
        },
        {
            "code": "163WX1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ostomy Care",
            "state": "MT",
            "license": "NUR-RN-LIC-198415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.