Misty Petersen, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

332191 Issued in AZ

Practice address

3555 Western Ave
Kingman, AZ 86409-3291

Phone

(928) 757-8440

NPI assigned

Nov 24, 2025

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

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Arizona Medical Group PLLCGroup PAC ID 6204901465, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northern Arizona Medical Group, PLLC

  • Specialist
  • Kingman, AZ
  • NPI 1770743965
  Medicare reassignment Care Compare group NPD
• Harmony Health & Wellness Center PLLC

  • Primary Care Nurse Practitioner
  • Lake Havasu City, AZ
  • NPI 1760331599
  NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kingman Healthcare, Inc

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917
  Care Compare affiliation

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

{
    "created_epoch": "1763942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769299200000",
    "number": "1891656328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2169 SWANSON AVE STE 1",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036878",
            "telephone_number": "928-575-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 WESTERN AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093291",
            "telephone_number": "928-757-8440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2169 Swanson Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864036878",
            "country_code": "US",
            "telephone_number": "928-575-2090 x89707",
            "fax_number": "480-885-3157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "MISTY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-24",
        "last_updated": "2026-01-25",
        "certification_date": "2026-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "332191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Mychel Pelham, DDS
• Katherine Pentz, M.S.W., L.C.S.W.
• Jessica Perez
• Aimee Perrine
• Brandon D Perry, DO
• Danna Marie Peterson, LPC
• Ngoc Pham, PHARMD.
• Sanana Phillips, NP
• Physiotherapy Associates
• Physiotherapy Associates Inc

• Family Nurse Practitioner in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.