Dustin Van Peterson, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Centerfield, UT
NPI 1609612969 · NPPES record last updated Jul 8, 2024
Key facts
- NPI
- 1609612969
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 14049839-4405 (UT)
- Practice address
- PO Box 220738
Centerfield, UT 84622-0738 - Phone
- (801) 851-0718
- NPI assigned
- Jul 6, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14049839-4405 | UT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utah State Department of Corrections | Past |
Accepting new patients | |
| State of Utah, Department of Health | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 14049839-4405 | UT | Yes |
Addresses
Primary practice location
PO Box 220738
Centerfield, UT 84622-0738
Mailing address
PO Box 220738
Centerfield, UT 84622-0738
Phone (801) 851-0718
Other providers in Centerfield, UT
- Shelby Lund
- Braige Lee Marsh
- Mayfield Community Care Center, Inc.
- Mission Health Services Inc
- Taleigh Petersen
- Jonda J. Purper
- Jaclyn Quarnberg
- Payton Sorensen
- Umatter Mentoring and Mental Health Services PLLC
- Valley Medical Inc
All providers in Centerfield, UT · Family Nurse Practitioner in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.