Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jimmie Ray Peterson

Individual provider Social Worker · NPI 1861144768

Jimmie Ray Peterson is a Social Worker in Eagan, Minnesota. Practices as a sole proprietor. Registered with an NPI since 2022.

In the registry since
2022
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Practice location Address checks out

2085 Jade Ln
Eagan, MN 55122-2862
Phone: (612) 619-1047
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X

Record details

NPI number1861144768
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 21, 2022
Last updated in NPPESJanuary 21, 2022
Certification dateJanuary 21, 2022

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