Jennie L Peters, PMHNP-BC, FNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2022152805 Issued in WI

Practice address

6032 40TH Ave
Kenosha, WI 53142-7018

Phone

(262) 287-1999

Fax

(262) 287-0884

NPI assigned

Jul 31, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Guided Wellness Counseling

  • Community/Behavioral Health Agency
  • Kenosha, WI
  • NPI 1093182941
  Medicare reassignment NPD

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1477743995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6032 40TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427018",
            "telephone_number": "262-287-1999",
            "fax_number": "262-287-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6032 40TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427018",
            "telephone_number": "262-287-1999",
            "fax_number": "262-287-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JENNIE",
        "middle_name": "L",
        "credential": "PMHNP-BC, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "2022152805",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "3146",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jawad Pervez
• Susanne Peschl, APNP
• Melissa Pestka
• Peter L. Emer, O.D.
• Brandi Peters, LAT
• Lori Peters, RN
• Bennet Petersen, MS, OTR/L
• Dawn Petersen, CSAC
• Jenny Petersen
• Kristen K Petersen, SLP

• Psychiatric/Mental Health Nurse Practitioner in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.