Individual
KELLY ANN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-BC
Contact information
Practice address
3186 S MARYLAND PKWY, LAS VEGAS, NV 89109-2317
(702) 961-5000
Mailing address
PO BOX 100744, ATLANTA, GA 30384-0744
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
866541
NV
Other
Enumeration date
04/19/2023
Last updated
08/14/2025
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