Individual
STACEY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3901 RAINBOW BLVD, MAIL STOP 2029, KANSAS CITY, KS 66160-8500
(913) 588-1619
Mailing address
3901 RAINBOW BLVD, MAIL STOP 2029, KANSAS CITY, KS 66160
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
120386
KS
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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