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

Katie Petersen

Individual provider Nurse Practitioner · NPI 1235571092

Katie Petersen is a Nurse Practitioner in Williamsport, Pennsylvania. Qualified in 2013, 13 years ago. Practices with Susquehanna Physician Services, a 612-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
13
Licensed in
PA
In the registry since
2013
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Practice location Address checks out

740 High St Ste 2001 Ste 2001
Williamsport, PA 17701-3102
Phone: (570) 321-2800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence SP012933 (PA)

Record details

NPI number1235571092
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 22, 2013
Last updated in NPPESMarch 25, 2021
Mailing address1201 Grampian Blvd, Suite 2001, Williamsport, PA 17701-1900

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Susquehanna Physician Services — 612 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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