Individual
HILARY A PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10500 QUIVIRA RD, OVERLAND PARK, KS 66215-2306
(913) 541-5340
(913) 541-5032
Mailing address
PO BOX 838, SHAWNEE MISSION, KS 66201-0838
(913) 469-4244
(913) 469-1939
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
430458
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200254670J
—
KS
05
—
200254670K
—
KS
01
—
33554071
BCBS OF KCMO GROUP 01674018
KS
01
—
33554081
BCBS OF KCMO GROUP 30492021
KS
01
—
P00666161
RR MEDICARE GROUP CG8899
KS
01
—
P00763781
RR MEDICARE GROUP DC6712
KS
Enumeration date
03/09/2006
Last updated
12/15/2009
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