Cynthia Denise Petersen

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

110796 Issued in NE

Practice address

415 S 25TH St
Omaha, NE 68131-3654

Phone

(402) 717-4673

NPI assigned

Jan 16, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

• Alegent Health Bergan Mercy Health System

  • Psychiatry Physician
  • Omaha, NE
  • NPI 1184897647
  NPD (past)
• Alegent Health Bergan Mercy Health System

  • Psychiatric Hospital Unit
  • Omaha, NE
  • NPI 1396969499
  NPD (past)
• Blue Valley Behavioral Health Inc

  • Community/Behavioral Health Agency
  • Beatrice, NE
  • NPI 1316019508
  NPD (past)
• Bryan Physician Network

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1679528798
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208995200000",
    "number": "1619028578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 EDUCATION DR",
            "city": "MALCOLM",
            "state": "NE",
            "postal_code": "684029573",
            "telephone_number": "402-796-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 25TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681313654",
            "telephone_number": "402-717-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "CYNTHIA",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2008-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "46338",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NE",
            "license": "110796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Lynn Petersen, APRN
• Angela Renee Petersen, P.T.
• Anthony Petersen
• Brian Douglas Petersen
• Courtney M Petersen
• Janell Petersen
• Jessica Lynette Petersen, LIMHP, LMHP, CMSW
• Joan Petersen
• Jocelyn Petersen
• Jodi Lyn Petersen, MS, NCC, LMHP, LPC

• Psychiatric/Mental Health Nurse Practitioner in Omaha, NE
• Providers in Omaha, NE by specialty
• Psychiatric/Mental Health Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.