Gabrielle Marie Petersen, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

091000238RN Issued in OR

Practice address

1713 Penn LN
Oregon City, OR 97045-1528

Phone

(503) 655-7725

Fax

(503) 655-7720

NPI assigned

Aug 2, 2013

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)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

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.

• Children'S Center

  • Child Abuse Pediatrics Physician
  • Oregon City, OR
  • NPI 1639349533
  NPD (past)

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375401600000",
    "number": "1912339896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 NE 37TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972122847",
            "telephone_number": "503-724-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 PENN LN",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451528",
            "telephone_number": "503-655-7725",
            "fax_number": "503-655-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "GABRIELLE",
        "middle_name": "MARIE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-02",
        "last_updated": "2013-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "091000238RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori A Perry, DPT
• Chloe Pete, MSW
• Agatha Peters
• Kathleen Peters
• Lindsay Allyson Peters
• Angela Peterson, DO
• Grant Ian Peterson
• Jamie Peterson, LMT
• Mara B Peterson, MD
• Shana K Peyser, MSW

• Pediatric Nurse Practitioner in Oregon City, OR
• Providers in Oregon City, OR by specialty
• Pediatric Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.