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CRYSTAL PETERSON
NPI 1073057352
Licensed Practical Nurse in Saint Louis, MO

Active since December 06, 2016
4066 DUNNICA AVE, SAINT LOUIS, MO 63116(636) 224-1230 Get Directions Write a Review

NPPES record last updated: July 28, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Crystal Peterson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRYSTAL PETERSON (NPI 1073057352) is an individual licensed practical nurse in Saint Louis, Missouri, licensed in Missouri (2015028944) and active in the NPI registry since December 2016.

NPPES Registry Identity

NPI1073057352
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameCRYSTAL PETERSON
Location Address4066 DUNNICA AVESaint Louis, MO 63116-3510
Mailing Address1601 Old South River RdSaint Charles, MO 63303-4120 · (636) 224-1210 · Fax (636) 246-1008
Phone(636) 224-1230
Sole ProprietorNo
Enumeration DateDecember 6, 2016
Last NPPES UpdateJuly 28, 2022
NPPES CertifiedJuly 28, 2022
✔ NPI 1073057352 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in MO · 2015028944
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
4066 DUNNICA AVE, Saint Louis, MO 63116
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Other Names 1

Former Name (1)Crystal Lee

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARIAH NELSON
Registered Nurse
4066 DUNNICA AVE
SAINT LOUIS, MO 63116
St. Louis City (636) 224-1700
ANGELA COLLINS
Registered Nurse
4066 DUNNICA AVE
SAINT LOUIS, MO 63116
St. Louis City (636) 224-1230
JEAN SOKORA MSW, LCSW
Social Worker (Clinical)
4066 DUNNICA AVE
SAINT LOUIS, MO 63116
St. Louis City (636) 224-1700
SAMANTHA A HARRIS LMSW
Social Worker (Clinical)
4066 DUNNICA AVE
SAINT LOUIS, MO 63116
St. Louis City (636) 224-1700
ANITA B POLZIN MA, LPC
Counselor (Professional)
4066 DUNNICA AVE
SAINT LOUIS, MO 63116
St. Louis City (636) 224-1700
VICTOR ANTOINO BROWDER RN
Registered Nurse
4066 DUNNICA AVE
SAINT LOUIS, MO 63116
St. Louis City (636) 224-1700
HAMPTON CHANDLER RN
Registered Nurse
4066 DUNNICA AVE
SAINT LOUIS, MO 63116
St. Louis City (636) 224-1700
STEPHANIE BURGESS LPN
Licensed Practical Nurse
4066 DUNNICA AVE
SAINT LOUIS, MO 63116
St. Louis City (636) 224-1700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crystal Peterson's NPI number?

The NPI number for Crystal Peterson is 1073057352. It was assigned to this individual provider in the NPPES registry on December 6, 2016. The provider is also known as Crystal Lee.

Where is Crystal Peterson located?

Crystal Peterson practices at 4066 Dunnica Ave, Saint Louis, MO 63116. The listed phone number is (636) 224-1230.

What is Crystal Peterson's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Crystal Peterson was last updated on July 28, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.