Louisa Peterson
Individual provider Active NPI Driver · N Las Vegas, NV
NPI 1891350989 · NPPES record last updated May 5, 2019
Key facts
- NPI
- 1891350989
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- NV20181835448 (NV)
- Practice address
- 3005 Shady Garden CT
N Las Vegas, NV 89031-3508 - Phone
- (775) 910-8003
- NPI assigned
- May 5, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NV20181835448 | NV | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | NV | ||
| Driver | 172A00000X | NV20181835448 | NV | Yes |
Addresses
Primary practice location
3005 Shady Garden CT
N Las Vegas, NV 89031-3508
Mailing address
3005 Shady Garden CT
N Las Vegas, NV 89031-3508
Phone (775) 910-8003
Other providers in N Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.