National Provider Identifier Database

KELLI A PETERSON, RN – NPI #1225276124
Licensed Practical Nurse

An individual 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.


Contact Information

KELLI A PETERSON, RN
73265 CONFEDERATED WAY
PENDLETON, OR97801
Phone: 541-966-9830
Fax:
Website:
Specialty Taxonomy Code
* Licensed Practical Nurse 164W00000X

* Indicates primary specialty

NPI Profile & details for KELLI A PETERSON

NPI Number 1225276124
Credentials RN (Registered Nurse)
Entity Individual
Enumeration date 01/30/2009
Last updated 01/30/2009 - About 17 years ago
Sole proprietor1 No
Identifiers
  • OR License #: 200843278RN
  • OR Medicaid: 171037
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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