Individual
AMANDA LOUISE PETERSMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-NP, MSN,CPNP-AC
Contact information
Practice address
7205 W CENTER RD, OMAHA, NE 68124-2380
(402) 830-3710
Mailing address
7205 W CENTER RD, OMAHA, NE 68124-2380
(402) 830-3710
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
111375
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025808500
—
NE
Enumeration date
08/07/2012
Last updated
10/16/2018
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