| Peterson Healthcare Llc | |
|
540 S Lahoma Ave Norman OK 73069-5526 | |
| (580) 235-1657 | |
| Not Available |
| Full Name | Peterson Healthcare Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 540 S Lahoma Ave, Norman, Oklahoma |
| Authorized Official Name and Position | Braden Peterson (NURSE PRACTITIONER / OWNER) |
| Authorized Official Contact | 5802351657 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peterson Healthcare Llc 540 S Lahoma Ave Norman OK 73069-5526 Ph: (580) 235-1657 | Peterson Healthcare Llc 540 S Lahoma Ave Norman OK 73069-5526 Ph: (580) 235-1657 |
| NPI Number | 1609414168 |
|---|---|
| Provider Enumeration Date | 12/16/2019 |
| Last Update Date | 01/28/2021 |
| Medicare PECOS PAC ID | 6103251988 |
|---|---|
| Medicare Enrollment ID | O20200124001837 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609414168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
| Provider Name | Denise Joan Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548568512 PECOS PAC ID: 8022144997 Enrollment ID: I20170127002097 |
| Provider Name | Braden Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245762020 PECOS PAC ID: 0941587430 Enrollment ID: I20170510002622 |
| Provider Name | Dina Biliske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417509951 PECOS PAC ID: 5890026074 Enrollment ID: I20191021000881 |
| Provider Name | Jana M Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568044501 PECOS PAC ID: 1850780933 Enrollment ID: I20211110002846 |
| Provider Name | Kandice Danielle Haines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306504964 PECOS PAC ID: 3375934037 Enrollment ID: I20220106002875 |
| Provider Name | Suzan Parks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720713340 PECOS PAC ID: 7315320058 Enrollment ID: I20220813000065 |
| Provider Name | Steven G Bander |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578545026 PECOS PAC ID: 5698799492 Enrollment ID: I20230315002469 |
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