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General NPI Number Information
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NPI Number | 1396125159
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Entity Type | Individual
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Provider Name | SARA PETERSON NP
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Gender | Female
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Dates
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Enumeration Date | 06/05/2015
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 4625 LINDELL BLVD FL 2
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City | SAINT LOUIS
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State | MO
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Zip | 63108-3739
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Country | US
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Telephone | 914-919-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 16240 FOSTER ST
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City | STILWELL
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State | KS
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Zip | 66085-8418
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Country | US
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Telephone | 913-894-8500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 76822
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License Number State | KS
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