Individual provider Active NPI

Amber Rose Petterle, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Kaysville, UT
National Provider Identifier
1609794379
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
C-APN.0107540-C-NP Issued in CO
Practice address
31 W Center St
Kaysville, UT 84037-1944
Phone
(801) 372-4761
NPI assigned
Jul 8, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X C-APN.0107540-C-NP CO Primary
Family Nurse Practitioner 363LF0000X 11459110-4405 UT

Addresses

Primary practice location

31 W Center St
Kaysville, UT 84037-1944

Mailing address

31 W Center St
Kaysville, UT 84037-1944

Other practice location 1

1351 Collyer St
Longmont, CO 80501-3310
Phone (303) 776-7117

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

NPI Registry JSON

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

{
    "created_epoch": "1783468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1609794379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W CENTER ST",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840371944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W CENTER ST",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840371944",
            "telephone_number": "801-372-4761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1351 Collyer St",
            "address_purpose": "LOCATION",
            "city": "Longmont",
            "state": "CO",
            "postal_code": "805013310",
            "country_code": "US",
            "telephone_number": "303-776-7117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTERLE",
        "first_name": "AMBER",
        "middle_name": "ROSE",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-08",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0107540-C-NP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11459110-4405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaysville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.