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

Kelli A Petersen, NP-C

Individual provider Adult Health Nurse Practitioner · NPI 1164702742

Kelli A Petersen, NP-C is a Nurse Practitioner in Minneapolis, Minnesota. Qualified in 2011, 15 years ago. Licensed in Minnesota.

Years since qualifying
15
Licensed in
MN
In the registry since
2011
What do these letters mean?
NP-C — Nurse Practitioner, Certified
A nurse practitioner certified by the AANP.

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Practice location Address checks out

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone: (612) 262-7800
Fax: (612) 262-7022
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 1676 (MN)

Record details

NPI number1164702742
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP-C
Sole proprietorNo
NPI enumeratedAugust 26, 2011
Last updated in NPPESJanuary 11, 2024
Certification dateJanuary 11, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Accepts Medicare assignment Not indicated

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