ANDRE PETERSON
NPI 1902569874
Licensed Practical Nurse in Suwanee, GA

Q: What is Andre Peterson's NPI number?

The NPI number for Andre Peterson is 1902569874. It was assigned to this individual provider in the NPPES registry on October 18, 2021.

Q: What is Andre Peterson'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 Andre Peterson was last updated on October 18, 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 October 18, 2021

2855 SUWANEE LAWRENCEVILLE RD, SUWANEE, GA 30024(770) 394-9055 Get Directions Write a Review

NPPES record last updated: October 18, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Andre Peterson NPPES

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

ANDRE PETERSON (NPI 1902569874) is an individual licensed practical nurse in Suwanee, Georgia, licensed in New York (098977) and active in the NPI registry since October 2021.

NPPES Registry Identity

NPI1902569874

Entity TypeIndividualMale

Primary Taxonomy164W00000X

Provider Legal NameANDRE PETERSON

Location Address2855 SUWANEE LAWRENCEVILLE RDSuwanee, GA 30024-3563

Mailing Address2058 Amber TrlDuluth, GA 30096-4935 · (917) 549-6511

Phone(770) 394-9055

Sole ProprietorYes

Enumeration DateOctober 18, 2021

NPPES CertifiedOctober 18, 2021

✔ NPI 1902569874 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 NY · 098977

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.

2855 SUWANEE LAWRENCEVILLE RD, Suwanee, GA 30024

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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 Andre Peterson's NPI number?

The NPI number for Andre Peterson is 1902569874. It was assigned to this individual provider in the NPPES registry on October 18, 2021.

Where is Andre Peterson located?

Andre Peterson practices at 2855 Suwanee Lawrenceville Rd, Suwanee, GA 30024. The listed phone number is (770) 394-9055.

What is Andre 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 Andre Peterson was last updated on October 18, 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.