Individual
KANDY LYNN PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
33244 W 87TH CIR, DE SOTO, KS 66018-8425
(620) 253-1575
Mailing address
33244 W 87TH CIR, DE SOTO, KS 66018-8425
(620) 253-1575
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
13-109135-052
KS
Other
Enumeration date
11/03/2022
Last updated
11/03/2022
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