Provider Demographics
NPI:1487490132
Name:NERVIO PAIN INSTITUTE
Entity type:Organization
Organization Name:NERVIO PAIN INSTITUTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:651-707-4042
Mailing Address - Street 1:612 ANACAPA ST APT A
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-1653
Mailing Address - Country:US
Mailing Address - Phone:805-272-0020
Mailing Address - Fax:651-666-1610
Practice Address - Street 1:612 ANACAPA ST APT A
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1653
Practice Address - Country:US
Practice Address - Phone:805-272-0020
Practice Address - Fax:651-666-1610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty