Andrea B Peterson, NP

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

R29648 Issued in ND

Practice address

737 Broadway
Fargo, ND 58122-0001

Phone

(701) 234-6060

Fax

(701) 234-7260

NPI assigned

Sep 5, 2008

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

Other identifiers 1

Other names 1

• Andrea B Bartholomay Former name

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": "1220572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1770731473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 BROADWAY",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581220001",
            "telephone_number": "701-234-6060",
            "fax_number": "701-234-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 BROADWAY",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581220001",
            "telephone_number": "701-234-6060",
            "fax_number": "701-234-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ANDREA",
        "middle_name": "B",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-05",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R29648",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "ND",
            "license": "R29648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19930",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "BARTHOLOMAY",
            "middle_name": "B",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Malea Peters, OTR/L
• Kaitlyn Janelle Petersen, OTR/L
• Nichole Petersen, LMT
• Peterson TCS LLC (Comfort Keepers)
• Amberlee Peterson, APRN, CNP
• Ashley Peterson
• Ashley Joy Peterson
• Bethany Peterson
• Brandi Peterson, APRN, FNP-C
• Brittney Peterson

• Neonatal Nurse Practitioner in Fargo, ND
• Providers in Fargo, ND by specialty
• Neonatal Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; 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.