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

Leah R Peterson

Individual provider Family Nurse Practitioner · NPI 1710600317

Leah R Peterson is a Nurse Practitioner in Kimberly, Wisconsin. Qualified in 2022, 4 years ago. Practices with Thedacare, Incorporated, a 654-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
4
Licensed in
WI
In the registry since
2022

Practice location Address checks out

520 W 3rd St
Kimberly, WI 54136-1300
Phone: (920) 788-7680
Show map & directions

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

Additional practice locations (1)

  • 3925 N Gateway Dr, Appleton, WI 54913-7863 — (920) 830-6877

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 13279-33 (WI)

Record details

NPI number1710600317
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 20, 2022
Last updated in NPPESOctober 9, 2024
Certification dateOctober 9, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Thedacare, Incorporated — 654 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Kimberly