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General NPI Number Information
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NPI Number | 1669864492
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Entity Type | Individual
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Provider Name | RACHAEL PETERSON
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Gender | Female
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Dates
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Enumeration Date | 03/03/2015
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Last Update Date | 01/27/2017
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Provider Practice Location Address
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Address Line | 8625 COLLEGE BLVD STE 103
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City | OVERLAND PARK
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State | KS
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Zip | 66210-2192
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Country | US
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Telephone | 913-777-0077
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Fax | 877-796-6309
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Provider Business Mailing Address
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Address Line | 8625 COLLEGE BLVD STE 103
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City | OVERLAND PARK
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State | KS
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Zip | 66210-2192
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Country | US
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Telephone | 913-777-0077
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Fax | 877-796-6309
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 76699
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License Number State | KS
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