MICHELLE K PETERSEN NP
NPI 1700041472
Nurse Practitioner in Two Rivers, WI

Q: What is Michelle Petersen's NPI number?

The NPI number for Michelle Petersen is 1700041472. It was assigned to this individual provider in the NPPES registry on July 22, 2008.

Q: What is Michelle Petersen'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 Michelle Petersen was last updated on November 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 July 22, 2008

5300 MEMORIAL DR, TWO RIVERS, WI 54241(920) 793-7400 Get Directions Write a Review

NPPES record last updated: November 30, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Nov 30, 2021, Feb 12, 2020, Nov 12, 2019 and 1 more (4 updates tracked since 2018).

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About Michelle K Petersen Np NPPES

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

MICHELLE K PETERSEN NP (NPI 1700041472) is an individual nurse practitioner in Two Rivers, Wisconsin, licensed in Wisconsin (8589-033) and active in the NPI registry since July 2008.

NPPES Registry Identity

NPI1700041472

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMICHELLE K PETERSENCredential: NP

Location Address5300 MEMORIAL DRTwo Rivers, WI 54241

Mailing Address5300 Memorial DrTwo Rivers, WI 54241-3923 · (920) 793-7400

Phone(920) 793-7400

Sole ProprietorNo

Enumeration DateJuly 22, 2008

Last NPPES UpdateNovember 30, 20214 updates tracked since enumeration

NPPES CertifiedNovember 30, 2021

✔ NPI 1700041472 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 WI · 8589-033

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 8589-33 (WI)

5300 MEMORIAL DR, Two Rivers, WI 54241

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Other Identifiers 1

Medicaid100080774WI

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.

JOANNA SMOGOLESKI

Nurse Practitioner