Individual provider · Type 1 NPI
Ebony Shandreka Peterson, FNP-BC, PMHNP-BC
Family Nurse Practitioner · Las Vegas, NV
NPI number
1396293841
Active
Practice location
2575 S Cimarron Rd Ste 104
Las Vegas, NV 89117-2682
Fax (725) 262-5536
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 821513 (NV) |
| Family Nurse Practitioner Primary | 363LF0000X | 821513 (NV) |
| Nurse Practitioner | 363L00000X | 821513 (NV) |
Family Nurse Practitioner: Definition to come...
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About NPI 1396293841
Ebony Shandreka Peterson, FNP-BC, PMHNP-BC's National Provider Identifier is 1396293841, issued on Sep 13, 2016. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Las Vegas, NV. The record was last updated on Oct 21, 2025.