MARY ELLEN PETERSON C-ANP - NPI 1083621445 - Nurse Practitioner in Stockholm, WI

Q: What is Mary Peterson's NPI number?

The NPI number for Mary Peterson is 1083621445. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Q: What is Mary Peterson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Peterson was last updated on April 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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About Mary Ellen Peterson C-anp NPPES

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

MARY ELLEN PETERSON C-ANP (NPI 1083621445) is an individual nurse practitioner in Stockholm, Wisconsin, licensed in Minnesota (0360774) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1083621445

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMARY ELLEN PETERSONCredential: C-ANP

Location AddressW12070 STATE HWY 35Stockholm, WI 54769-6127

Mailing AddressW12070 State Hwy 35Stockholm, WI 54769-6127 · (715) 821-8532 · Fax (715) 442-2351

Phone(715) 821-8532

Fax(715) 442-2351

Sole ProprietorNo

Enumeration DateAugust 1, 2006

Last NPPES UpdateApril 7, 2025

✔ NPI 1083621445 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MN · 0360774

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License 4576-033 (WI)

W12070 STATE HWY 35, Stockholm, WI 54769

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Other Identifiers 3

Other0404556MN · Medica

Medicaid243994800MN

Other090M9PEMN · Blue Cross Blue Shield

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 Mary Peterson's NPI number?

The NPI number for Mary Peterson is 1083621445. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Where is Mary Peterson located?

Mary Peterson practices at W12070 State Hwy 35, Stockholm, WI 54769. The listed phone number is (715) 821-8532.

What is Mary Peterson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Mary Peterson was last updated on April 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.