Lana J. Peterson, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP1740 Issued in AZ

Practice address

1041 S Lebaron
Mesa, AZ 85210-3630

Phone

(480) 788-4628

Fax

(866) 812-0853

NPI assigned

May 10, 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

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

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 and National Provider Directory roles.

• Life Journey Psychiatric PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chandler, AZ
  • NPI 1609930932
  NPD (past) Authorized official
• Lifespan Behavioral Health, LLC

  • Clinical Psychologist
  • Mesa, AZ
  • NPI 1033229281
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1972553360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2487 S GILBERT RD STE 106-180",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852952809",
            "telephone_number": "480-200-9580",
            "fax_number": "866-812-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 S LEBARON",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103630",
            "telephone_number": "480-788-4628",
            "fax_number": "866-812-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LANA",
        "middle_name": "J.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP1740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "787757",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Calli Tansa Peterson
• Charles Smith Peterson, M.D.
• Denise Peterson, LIAC
• Eric Peterson
• Kelsey Peterson, LMSW
• Laurie Lee Peterson, P.A.
• Lesilie A Peterson, RDH
• Lindsey Peterson, RBT
• Robert Peterson, M.D.
• Sheryl L Peterson, CPNP

• Psychiatric/Mental Health Nurse Practitioner in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.