Individual
DELAYNE K PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
(402) 559-7741
(402) 552-3655
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
(402) 559-7741
(402) 552-3655
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
242
NE
363AM0700X
Medical Physician Assistant
242
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37818
BCBS OF NEBRASKA
NE
Enumeration date
08/30/2006
Last updated
12/04/2012
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