Peterson, Tara L.

Peterson, Tara L. is an individual health care provider with primary practice located at 8901 Indian Hills Dr Suite 200, Omaha NE 68114-4057. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Peterson, Tara L. can be contacted via phone (402) 397-7057.

Contact Information

Primary practice address
8901 Indian Hills Dr Suite 200 Omaha NE 68114-4057
Phone: (402) 397-7057
Fax: (402) 397-6656
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 110711 Nebraska

Profile Details

NPI number 1235108457
LBN Legal business name Peterson, Tara L.
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Dec 8th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235108457 NPPES
Nebraska MEDICAID 47077295213
Nebraska MEDICAID 10025290600

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