Individual
JANE A PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2220 HOLMES ST, KANSAS CITY, MO 64108-2639
(816) 235-5963
Mailing address
526 BRENT DR, BONNER SPRINGS, KS 66012
(402) 415-3868
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2006031910
MO
363LF0000X
Family Nurse Practitioner
44809
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47078557536
—
NE
Enumeration date
07/06/2006
Last updated
02/17/2009
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