Mary Petruzzi, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN2269965 Issued in MA

Practice address

9900 Bren Rd E
Minnetonka, MN 55343-9664

Phone

(203) 605-0804

NPI assigned

Jun 7, 2006

Last updated

Mar 3, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Care Associates, LLC

  • Nurse Practitioner
  • Old Saybrook, CT
  • NPI 1992845481
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1922048073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 SHERMAN HILL RD APT C10",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067983641",
            "telephone_number": "203-605-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "203-605-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUZZI",
        "first_name": "MARY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2021-03-03",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F333230-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "002938",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2269965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra J Peterson, RN, CFNP
• Gretchen Elsa Peterson, LICSW
• Kathleen Marie Frischmann Peterson, PSYD, LP
• Sieglinde Iris Peterson, M.D.
• Melissa Ann Petoletti, MS, LPCC, LADC
• Laura Marie Pett, MA CCC A
• Jennifer Petzoldt
• Crystal A Pfisterer, D.C.
• Laura Jean Philbrook, RN
• Elizabeth Lowe Robinson Phillips, DDS

• Family Nurse Practitioner in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.