Healthcare Provider Details

I. General information

NPI: 1497733711
Provider Name (Legal Business Name): LILLIAN FERN PETERS RN ARNO BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 E 1ST ST
NEWTON KS
67114-0467
US

IV. Provider business mailing address

1901 E 1ST ST
NEWTON KS
67114-0467
US

V. Phone/Fax

Practice location:
  • Phone: 316-284-6400
  • Fax: 316-284-6491
Mailing address:
  • Phone: 316-284-6400
  • Fax: 316-284-6491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License Number1324579092
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number74328
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: