Kristine Charli Petersen

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

20650 Glenn St
Elkhorn, NE 68022-2324

Phone

(402) 334-9302

NPI assigned

Nov 10, 2022

Sex

Female

Sole proprietor

Yes

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

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.

• Elkhorn Public Schools

  • Local Education Agency (LEA)
  • Elkhorn, NE
  • NPI 1790438018
  NPD

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1972211795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20650 GLENN ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680222324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20650 GLENN ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680222324",
            "telephone_number": "402-334-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "KRISTINE",
        "middle_name": "CHARLI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peaceful Hearts Hospice LLC
• Jerris L Peatrowsky, APRN
• Matthew T Perry, DPT
• William Seth Perry, DPT
• Emma Petersen
• Emma Louise Peterson, RD, ATC
• Margaret J Peterson, APRN
• Allison H. Phillips, M.D.
• Margaret Phillips
• Noelle C Phillips, LICSW, LIMHP

• Personal Care Attendant in Elkhorn, NE
• Providers in Elkhorn, NE by specialty
• Personal Care Attendant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.