Individual
NICKY PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
646 CANARY CIR, FERNLEY, NV 89408-6501
(775) 722-5985
Mailing address
646 CANARY CIR, FERNLEY, NV 89408-6501
(775) 722-5985
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/06/2020
Last updated
11/06/2020
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