Individual provider · Type 1 NPI

Kyrie Allison Peterson

Nurse Practitioner · Fort Wayne, IN

NPI number 1336871318 Active

Practice location

5693 Ymca Park Dr W
Fort Wayne, IN 46835-3280

Call (260) 469-6603 Map

Fax (260) 486-6123

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X71012788A (IN)

Nurse Practitioner: (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 wit…

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About NPI 1336871318

Kyrie Allison Peterson's National Provider Identifier is 1336871318, issued on Jun 28, 2022. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Fort Wayne, IN. The record was last updated on Oct 17, 2022.