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

Individual provider Family Nurse Practitioner · NPI 1891656328

Misty Petersen, FNP-C is a Nurse Practitioner in Kingman, Arizona. Qualified in 2025, 1 year ago. Practices with Northern Arizona Medical Group PLLC, a 5-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
1
Licensed in
AZ
In the registry since
2025
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

3555 Western Ave
Kingman, AZ 86409-3291
Phone: (928) 757-8440
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2169 Swanson Ave Ste 1, Lake Havasu City, AZ 86403-6878 — (928) 575-2090

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 332191 (AZ)

Record details

NPI number1891656328
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedNovember 24, 2025
Last updated in NPPESJanuary 25, 2026
Certification dateJanuary 25, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Northern Arizona Medical Group Pllc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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