Individual provider · Type 1 NPI
Lidia Timofeenko Petersen
Psychiatric/Mental Health Nurse Practitioner · Las Vegas, NV
NPI number
1245857952
Active
Practice location
972 Sugar Springs Dr
Las Vegas, NV 89110-2936
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 53260 (ID) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | TEMP53260 (ID) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 835379 (NV) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1245857952
Lidia Timofeenko Petersen's National Provider Identifier is 1245857952, issued on Jun 29, 2020. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Las Vegas, NV. The record was last updated on Sep 6, 2022.