Individual
EBONY ANDREA PETERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
(785) 239-3627
Mailing address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-81444
KS
Other
Enumeration date
03/20/2020
Last updated
07/11/2023
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