Individual
NICOLLE LYNETTE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
EMILE AT 42ND ST, OMAHA, NE 68198-3406
(402) 552-6731
(402) 552-6730
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11016297A
IN
207R00000X
Internal Medicine Physician
Primary
1647
NE
207R00000X
Internal Medicine Physician
OS13016
FL
208M00000X
Hospitalist Physician
OS13016
FL
Other
Enumeration date
07/01/2011
Last updated
08/15/2017
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