Katherine A Petersen, C.N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R0794675 Issued in MN

Practice address

225 Smith Ave N
Suite 300
Saint Paul, MN 55102-2533

Phone

(651) 726-6200

Fax

(651) 241-0992

NPI assigned

Jul 20, 2006

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

Certified Nurse Practitioner

State licenses

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1902826258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 SMITH AVE N",
            "address_2": "SUITE 300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022533",
            "telephone_number": "651-726-6200",
            "fax_number": "651-241-0992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "KATHERINE",
        "middle_name": "A",
        "credential": "C.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R0794675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "500015512",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel L Petersen-Nguyen, MD
• Clairessa Elaine Petersen
• Haley Petersen
• John Robert Petersen, D.C.
• Karl John Petersen, DDS
• Linda Louise Petersen, RN, BSN
• Mitchell Petersen
• Peterson & Peterson DDS PA
• Peterson Dental PA
• Abigail Ellen Peterson, M.D.

• Nurse Practitioner in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; 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.