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

Tara Peterson, APNP

Individual provider Registered Nurse · NPI 1144045444

Tara Peterson, APNP is a Nurse Practitioner in Green Bay, Wisconsin. Qualified in 2023, 3 years ago. Practices with Advanced Ear Nose and Throat Specialists, SC, a 33-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
3
Licensed in
WI
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

2654 S Oneida St Stop 102
Green Bay, WI 54304-5337
Phone: (888) 938-3838
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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 15899-33 (WI)
Registered Nurse Taxonomy 163W00000X · Licence 197282-30 (WI)

Record details

NPI number1144045444
Entity typeIndividual (Type 1)
GenderFemale
Credentials APNP
Sole proprietorNo
NPI enumeratedNovember 21, 2024
Last updated in NPPESDecember 13, 2024
Certification dateDecember 13, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Advanced Ear Nose And Throat Specialists, Sc — 33 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Green Bay