Individual
ELIZABETH A PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
805 E MAIN ST, FERNLEY, NV 89408-9743
(775) 204-4000
(775) 234-4605
Mailing address
5975 S LOS ALTOS PKWY, SPARKS, NV 89436-7699
(775) 204-4000
(775) 234-4605
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2889
NV
363A00000X
Physician Assistant
61188057
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2889
PA-C
NV
01
—
61188057
PA ACTIVE
WA
Enumeration date
07/28/2021
Last updated
08/07/2026
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