Individual
MRS. EBONY SHANDREKA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC, PMHNP-BC
Contact information
Practice address
2575 S CIMARRON RD STE 104, LAS VEGAS, NV 89117-2682
(725) 712-4625
(725) 262-5536
Mailing address
2575 S CIMARRON RD STE 104, LAS VEGAS, NV 89117-2682
(725) 712-4625
(725) 262-5536
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
821513
NV
363LF0000X
Family Nurse Practitioner
Primary
821513
NV
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
821513
NV
Other
Enumeration date
09/13/2016
Last updated
10/21/2025
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