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

Katie Marie Peterson, AGNP

Individual provider Gerontology Nurse Practitioner · NPI 1508265331

Katie Marie Peterson, AGNP is a Nurse Practitioner in Saint Louis Park, Minnesota. Graduated from Yale University School of Medicine in 2014, 12 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
12
Trained at
Yale University School of Medicine
Licensed in
MN
In the registry since
2014
Specialties on file
2
What do these letters mean?
AGNP — Adult-Gerontology Nurse Practitioner
A nurse practitioner focused on adults and older people.

See every abbreviation used in this directory →

Practice location Address checks out

3931 Louisiana Ave S Ste E202
Saint Louis Park, MN 55426-5000
Phone: (952) 993-9184
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 3298 (MN)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence AG0614152 (MN)

Record details

NPI number1508265331
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP
Sole proprietorYes
NPI enumeratedAugust 18, 2014
Last updated in NPPESMarch 10, 2021
Certification dateMarch 10, 2021

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolYALE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2014 (12 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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