Individual provider · Type 1 NPI

Judy L. Peterson, CNNP CPNP

Pediatric Nurse Practitioner · St. Paul, MN

NPI number 1033177985 Active

Practice location

347 North Smith Ave, Childrens Specialty Clinic Nicu
St. Paul, MN 55102

Fax (651) 220-7777

Mailing address

2910 Centre Pointe Dr, 35-121A Childrens Health Care
Roseville, MN 55113

Specialties and licenses

TaxonomyCodeLicense
Neonatal Nurse Practitioner 363LN0000XR1013148 (MN)
Critical Care Neonatal Nurse Practitioner 363LN0005XR1013148 (MN)
Pediatric Nurse Practitioner Primary 363LP0200XR1013148 (MN)

Pediatric Nurse Practitioner: Definition to come...

5 other providers at this address

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About NPI 1033177985

Judy L. Peterson, CNNP CPNP's National Provider Identifier is 1033177985, issued on May 2, 2006. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in St. Paul, MN. The record was last updated on Jul 13, 2026.