Kristy L Petersen
Nurse Practitioner - Gerontology
540 The Rialto
Venice
, Florida 34285-2900
Kristy L Petersen
Nurse Practitioner - Gerontology
540 The Rialto
Venice
, Florida 34285-2900
(941) 486-6931
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Kristy L Petersen
- Po Box 850001
- Orlando, FL
- Zip : 32885-0001
- Fax : (941) 486-6931
- Phone : (941) 486-6927
Second Address
- Kristy L Petersen
- 540 The Rialto
- Venice, FL
- Zip : 34285-2900
- Fax : (941) 486-6931
- Phone : (941) 486-6927
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | ARNP9335906 | FL |
National Provider Identifier
| NPI | 1003313115 |
|---|---|
| Provider Name | Kristy L Petersen |
| First Address | Orlando, FL 32885-0001 |
| Second Address | Venice, FL 34285-2900 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/04/2018 |
| Last Update Date | 06/04/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| ARNP9335906 | ARNP LICENSE (01) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.