Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tina Renae Peterson, APRN-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1528747896

Tina Renae Peterson, APRN-BC is a Nurse Practitioner in Ada, Oklahoma. Qualified in 2022, 4 years ago. Practices with Millennium Medical Services, LLC, a 24-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oklahoma.

Years since qualifying
4
Licensed in
OK
In the registry since
2023
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Practice location Address checks out

1000 Rolling Hills Ln
Ada, OK 74820-9415
Phone: (580) 436-3600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 214202 (OK)

Record details

NPI number1528747896
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN-BC
Sole proprietorYes
NPI enumeratedJuly 14, 2023
Last updated in NPPESJuly 14, 2023
Certification dateJuly 11, 2023

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 Millennium Medical Services, Llc — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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