MEDICARE: KERRIE L PETECH R.N. ARNP-CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP61405417	WA
2	163W00000X	Registered Nurse	60178019	WA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	74724	ID

General Provider Information

NPI Number	:	1265414544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERRIE L PETECH R.N. ARNP-CNP

Provider Business Mailing Address
First Line	:	1859 S TOPAZ WAY STE 100
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-4401
Country	:	US
Telephone Number	:	208-209-2432
Fax Number	:

Provider Business Practice Location Address
First Line	:	1859 S TOPAZ WAY STE 100
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-4401
Country	:	US
Telephone Number	:	208-209-2432
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	03/13/2026

Similar Medicare Providers

1194065730 — RUSSELL BOLTON HARMONY NP
Practice Location Address:

1859 S TOPAZ WAY STE 106
MERIDIAN, ID
83642-4401

Practice Phone: 208-672-4640
Practice Fax: 208-957-6300

1194105395 — HEATHER HAINSTOCK PSY.D.
Practice Location Address:

1859 S TOPAZ WAY STE 100
MERIDIAN, ID
83642-4401

Practice Phone: 208-209-2432
Practice Fax: 847-859-5885

1306291836 — IDAHO SPINE & PAIN PLLC
Practice Location Address:

1859 S TOPAZ WAY STE 106
MERIDIAN, ID
83642-4401

Practice Phone: 208-672-4640
Practice Fax: 208-957-6300

1144778309 — MRS. CIERRA NICOLE NEIWERT RDN
Practice Location Address:

1859 S TOPAZ WAY STE 100
MERIDIAN, ID
83642-4401

Practice Phone: 208-209-2432
Practice Fax: 848-859-5885

1285141119 — MADDIE LIDDIARD LMSW
Practice Location Address:

1859 S TOPAZ WAY STE 100
MERIDIAN, ID
83642-4401

Practice Phone: 208-209-2432
Practice Fax:

1740797125 — JENNA CAYWOOD LMSW
Practice Location Address:

1859 S TOPAZ WAY STE 100
MERIDIAN, ID
83642-4401

Practice Phone: 208-209-2432
Practice Fax: 847-859-5885

Directions to “ KERRIE L PETECH R.N. ARNP-CNP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.