Nancy M Petersen, NP

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

195833 Issued in MA

Practice address

100 Wendell Ave
Suite 1
Pittsfield, MA 01201-7065

Phone

(413) 443-2844

NPI assigned

Mar 1, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1881722866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 WEST RD",
            "city": "STEPHENTOWN",
            "state": "NY",
            "postal_code": "121683613",
            "telephone_number": "413-499-8568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WENDELL AVE",
            "address_2": "SUITE 1",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012017065",
            "telephone_number": "413-443-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "NANCY",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "MA",
            "license": "195833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Nurse Practitioner in Pittsfield, MA
• Providers in Pittsfield, MA by specialty
• Obstetrics & Gynecology Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.