Nicole Lee Petteys, CRPA-P

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

5528 Issued in NY

Practice address

10 1St Ave
Gloversville, NY 12078-3102

Phone

(518) 725-5646

NPI assigned

Jun 29, 2026

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1782691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1477479855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LOOMIS ST APT 2",
            "city": "LITTLE FALLS",
            "state": "NY",
            "postal_code": "133651522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 1ST AVE",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120783102",
            "telephone_number": "518-725-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTEYS",
        "first_name": "NICOLE",
        "middle_name": "LEE",
        "credential": "CRPA-P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-29",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NY",
            "license": "5528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Lynn Peck, LPN
• Raquel Perez, MRC
• Vimilla Persaud
• Michelle Marie Peryea, RN
• David Roy Pesses, M.D.
• Jessica Pinkerton
• Emily Kathryn Planz
• Ashlee Erin Podolec, NP
• Tyler William Popp
• Sara Jassner Poquette, MS

• Peer Specialist in Gloversville, NY
• Providers in Gloversville, NY by specialty
• Peer Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.

Verify at the official NPI Registry.