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KATIE LYNNE PETERSON PA-C
NPI 1528119906
Physician Assistant - Medical in Prescott Valley, AZ

Active since January 14, 2007
3151 N WINDSONG DR, PRESCOTT VALLEY, AZ 86314(928) 778-4711 Get Directions Write a Review

NPPES record last updated: May 10, 2017. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: May 10, 2017, Mar 25, 2017, Aug 18, 2016 (3 updates tracked since 2016).

About Katie Lynne Peterson Pa-c NPPES

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

KATIE LYNNE PETERSON PA-C (NPI 1528119906) is an individual medical provider in Prescott Valley, Arizona, licensed in Arizona (6032) and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1528119906
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameKATIE LYNNE PETERSONCredential: PA-C
Location Address3151 N WINDSONG DRPrescott Valley, AZ 86314-2240
Mailing Address12262 E Bradshaw Mtn RdDewey, AZ 86327-6032 · (928) 772-1673
Phone(928) 778-4711
Sole ProprietorNo
Enumeration DateJanuary 14, 2007
Last NPPES UpdateMay 10, 20173 updates tracked since enumeration
✔ NPI 1528119906 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
Licenses✔ Licensed in AZ · 6032✔ Licensed in CA · PA21714
Also ListedSpecialist/Technologist · Athletic TrainerTaxonomy 2255A2300X · License 36001348A (IN)
3151 N WINDSONG DR, Prescott Valley, AZ 86314
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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 Katie Peterson's NPI number?

The NPI number for Katie Peterson is 1528119906. It was assigned to this individual provider in the NPPES registry on January 14, 2007.

Where is Katie Peterson located?

Katie Peterson practices at 3151 N Windsong Dr, Prescott Valley, AZ 86314. The listed phone number is (928) 778-4711.

What is Katie Peterson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Katie Peterson was last updated on May 10, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.