Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Emily C Peterson, PA-C

Individual provider Surgical Physician Assistant · NPI 1578979654

Emily C Peterson, PA-C is a Physician Assistant in St Louis Park, Minnesota. Qualified in 2014, 12 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
12
Licensed in
MN
In the registry since
2014
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3931 Louisiana Ave S
St Louis Park, MN 55426-5000
Phone: (952) 993-3230
Fax: (952) 993-1748
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3580 Arcade St, Vadnais Heights, MN 55127-7135 — (651) 968-5200

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 11667 (MN)

Record details

NPI number1578979654
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 9, 2014
Last updated in NPPESMay 4, 2022
Certification dateMay 4, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in St Louis Park