MRS. JENNIFER MARY PETERSEN LPN
NPI 1417308578
Licensed Practical Nurse in Sullivan, WI

Q: What is Jennifer Petersen's NPI number?

The NPI number for Jennifer Petersen is 1417308578. It was assigned to this individual provider in the NPPES registry on June 29, 2016. The provider is also known as Jennifer Mary Vick Lpn.

Q: What is Jennifer Petersen's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jennifer Petersen was last updated on June 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.

Active since June 29, 2016

417 GROVE ST, SULLIVAN, WI 53178(920) 988-3499 Get Directions Write a Review

NPPES record last updated: June 29, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mrs. Jennifer Mary Petersen Lpn NPPES

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

MRS. JENNIFER MARY PETERSEN LPN (NPI 1417308578) is an individual licensed practical nurse in Sullivan, Wisconsin, licensed in Wisconsin (31454231) and active in the NPI registry since June 2016.

NPPES Registry Identity

NPI1417308578

Entity TypeIndividualFemale

Primary Taxonomy164W00000X

Provider Legal NameMRS. JENNIFER MARY PETERSENCredential: LPN

Location Address417 GROVE STSullivan, WI 53178-9770

Mailing Address417 Grove StSullivan, WI 53178-9770 · (920) 988-3499

Phone(920) 988-3499

Sole ProprietorYes

Enumeration DateJune 29, 2016

✔ NPI 1417308578 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 WI · 31454231

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.

417 GROVE ST, Sullivan, WI 53178

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Other Names 1

Former Name (1)Jennifer Mary Vick Lpn

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 Jennifer Petersen's NPI number?

The NPI number for Jennifer Petersen is 1417308578. It was assigned to this individual provider in the NPPES registry on June 29, 2016. The provider is also known as Jennifer Mary Vick Lpn.

Where is Jennifer Petersen located?

Jennifer Petersen practices at 417 Grove St, Sullivan, WI 53178. The listed phone number is (920) 988-3499.

What is Jennifer Petersen'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 Jennifer Petersen was last updated on June 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.