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Individual

MS. CYNTHIA DENISE PETERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
415 S 25TH ST, OMAHA, NE 68131-3654
(402) 717-4673
Mailing address
511 EDUCATION DR, MALCOLM, NE 68402-9573
(402) 796-2422

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
46338
NE
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
110796
NE

Other

Enumeration date
01/16/2007
Last updated
04/24/2008
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