MRS. EBONY SHANDREKA PETERSON FNP-BC PMHNP-BC NPI 1396293841

NPI Information

NPI: 1396293841
Provider Name: MRS. EBONY SHANDREKA PETERSON, FNP-BC, PMHNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
4344 W CHEYENNE AVE
NORTH LAS VEGAS, NV
ZIP 89032
Phone: (702) 350-2032
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MRS. Ebony Shandreka Peterson, FNP-BC, PMHNP-BC is a family nurse practitioner in North Las Vegas, NV. MRS. Ebony Shandreka Peterson, FNP-BC, PMHNP-BC NPI is 1396293841. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4344 W CHEYENNE AVE
NORTH LAS VEGAS, NV
ZIP 89032-484
Phone: (702) 350-2032
Fax: (725) 262-5536

The NPI 1396293841 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/13/2016 and was last updated on 4/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		821513	NEVADA	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	821513	NEVADA	No
3	363LF0000X	Nurse Practitioner	Family	821513	NEVADA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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