Individual
DANA D PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
7440 S 91ST ST, LINCOLN, NE 68526-9797
(402) 489-6555
(402) 328-3770
Mailing address
7440 S 91ST ST, LINCOLN, NE 68526-9797
(402) 489-6555
(402) 328-3770
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
902
NE
363AM0700X
Medical Physician Assistant
Primary
902
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026072000
—
NE
05
—
10026072500
—
NE
05
—
10026072600
—
NE
05
—
200598590A
—
KS
Enumeration date
10/04/2006
Last updated
02/01/2012
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