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

Preston Lee Peterson, AGACNP

Individual provider Acute Care Nurse Practitioner · NPI 1801453030

Preston Lee Peterson, AGACNP is a Nurse Practitioner in Reno, Nevada. Qualified in 2019, 7 years ago. Practices with Northern Nevada Medical Group LLC, a 87-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Nevada.

Years since qualifying
7
Licensed in
NV
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

1500 E 2nd St Ste 100
Reno, NV 89502-1189
Phone: (775) 982-5003
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 822824 (NV)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 822824 (NV)

Record details

NPI number1801453030
Entity typeIndividual (Type 1)
GenderMale
Credentials AGACNP
Sole proprietorNo
NPI enumeratedMay 22, 2019
Last updated in NPPESMay 20, 2021
Certification dateMay 20, 2021

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Northern Nevada Medical Group Llc — 87 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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