Individual
KATHLEEN LAVONNE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
343 FAIRVIEW DR STE 101, CARSON CITY, NV 89701-5389
(775) 887-5683
Mailing address
3810 AMBER ST, SILVER SPRINGS, NV 89429-9328
(775) 223-2597
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
05/24/2019
Last updated
05/24/2019
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