Denise K Peterson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

52094 Issued in TX

Practice address

902 W Randol Mill Rd
Ste 200
Arlington, TX 76012-2572

Phone

(817) 461-3003

Fax

(817) 275-2525

NPI assigned

Oct 26, 2006

Last updated

Dec 8, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1730264987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16980 DALLAS PKWY",
            "address_2": "STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481908",
            "telephone_number": "817-461-3003",
            "fax_number": "817-469-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 W RANDOL MILL RD",
            "address_2": "STE 200",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760122572",
            "telephone_number": "817-461-3003",
            "fax_number": "817-275-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DENISE",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "52094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187125301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaylee Michelle Peters
• Michelle Nicole Peters, D.C.
• Tyyan Peters, MS, CCC-SLP
• Sarah Petersen
• Caroline Peterson
• Essence Peterson
• Jill Peterson, DDS, MPH, PHD
• Nikita Marie Peterson
• Alice D Petranek, OTR/L
• Nicholaus Petterson, D.C.

• Nurse Practitioner in Arlington, TX
• Providers in Arlington, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.