Individual
MOYA C PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.R.N.P.
Contact information
Practice address
3901 RAINBOW BLVD, MS 4017, KANSAS CITY, KS 66160-8500
(913) 588-1944
(913) 588-2496
Mailing address
PO BOX 411851, KANSAS CITY, MO 64141-1851
(913) 588-1944
(913) 588-2496
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
44161
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100248630B
—
KS
01
—
26926013
BCBS KANSAS CITY
MO
01
—
412690
FIRSTGUARD
KS
05
—
424843506
—
MO
01
—
500008548
RAILROAD MEDICARE
—
Enumeration date
09/15/2006
Last updated
07/16/2014
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