Bonnie Louise Peterson

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

RN00056442 Issued in WA

Practice address

412 Lilly Rd NE
Olympia, WA 98506-5132

Phone

(360) 867-2543

Fax

(360) 867-2601

NPI assigned

Jul 12, 2012

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1730444910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065132",
            "telephone_number": "360-867-2543",
            "fax_number": "360-867-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065132",
            "telephone_number": "360-867-2543",
            "fax_number": "360-867-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BONNIE",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-12",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "WA",
            "license": "RN00056442",
            "primary": true
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "WA",
            "license": "RN00056442",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Sue Petersen-Hobbs, CMHC
• Dana M Petersen, M.D.
• Iris Havlina Donovan Petersen, MD
• Morrigan Piper Petersen, CPC
• Anneliese Mendenhall Peterson, CPM, LM
• John E Peterson, OD
• Malgorzata Dymerska Peterson, MD
• Rebecca J Peterson, A.R.N.P.
• William W. Peterson, M.D.
• Jeffrey Robert Petra, PH.D.

• Case Management Registered Nurse in Olympia, WA
• Providers in Olympia, WA by specialty
• Case Management Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; 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.