| NPI | 1669337630 |
|---|---|
| Former Name | AMANDA E PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-85174) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-146718) |
| Enumeration Date | 2025-12-22 |
| Last Update Date | 2026-01-15 |