Individual
MS. STACIE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CDE
Contact information
Practice address
430 N MONITOR ST, WEST POINT, NE 68788-1595
(402) 372-2404
(402) 372-2360
Mailing address
430 N MONITOR ST, WEST POINT, NE 68788-1595
(402) 372-2404
(402) 372-2360
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
49907
NE
163WD0400X
Diabetes Educator Registered Nurse
49907
NE
Other
Enumeration date
10/03/2014
Last updated
10/03/2014
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