Individual provider · Type 1 NPI

Travis Dale Peterson, NP

Neonatal Nurse Practitioner · Provo, UT

NPI number 1467195552 Active

Practice location

1034 N 500 W
Provo, UT 84604-3380

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Specialties and licenses

TaxonomyCodeLicense
Neonatal Nurse Practitioner Primary 363LN0000X8058003-4405 (UT)

Neonatal Nurse Practitioner: Definition to come...

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About NPI 1467195552

Travis Dale Peterson, NP's National Provider Identifier is 1467195552, issued on Apr 15, 2022. The primary taxonomy on file is Neonatal Nurse Practitioner (363LN0000X), and the practice location is in Provo, UT. The record was last updated on Feb 17, 2026.