Active NPI
Rebecca Marie Peterson, RN
- Registered Nurse
- Kennewick, WA
National Provider Identifier
1639859150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN60765920
- Practice address
- 804 W 43Rd Ave
Kennewick, WA 99337-4515 - Phone
- (509) 948-2343
- NPI assigned
- Jul 19, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | NUR-RN-LIC-179226 | MT | |
| Registered Nurse | 163W00000X | 171766 | IA | |
| Registered Nurse | 163W00000X | RN.1685920 | CO | |
| Registered Nurse | 163W00000X | 1103083-30 | WI | |
| Registered Nurse | 163W00000X | RN60765920 | WA | Primary |
| Registered Nurse | 163W00000X | 158979 | KS | |
| Registered Nurse | 163W00000X | 96247 | NE | |
| Registered Nurse | 163W00000X | 71585 | NM |
Addresses
Primary practice location
804 W 43Rd Ave
Kennewick, WA 99337-4515
Mailing address
804 W 43Rd Ave
Kennewick, WA 99337-4515
Phone (509) 948-2343
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN.1685920 | CO | MD | Registered Nurse |
| 171766 | IA | MD | Registered Nurse |
| 158979 | KS | MD | Registered Nurse |
| NUR-RN-LIC-179226 | MT | MD | Registered Nurse |
| 96247 | NE | MD | Registered Nurse |
| 71585 | NM | MD | Registered Nurse |
| RN60765920 | WA | MD | Registered Nurse |
| 1103083-30 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689724800000",
"number": "1639859150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 W 43RD AVE",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993374515",
"telephone_number": "509-948-2343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 W 43RD AVE",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993374515",
"telephone_number": "509-948-2343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "REBECCA",
"middle_name": "MARIE",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-19",
"last_updated": "2023-07-19",
"certification_date": "2023-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MT",
"license": "NUR-RN-LIC-179226",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IA",
"license": "171766",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CO",
"license": "RN.1685920",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "1103083-30",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN60765920",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "KS",
"license": "158979",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NE",
"license": "96247",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NM",
"license": "71585",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kennewick, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.