Provider Demographics
NPI:1689470221
Name:PETERSON, NANCY RUTH
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:RUTH
Last Name:PETERSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83958 HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NE
Mailing Address - Zip Code:68821-5118
Mailing Address - Country:US
Mailing Address - Phone:308-880-0201
Mailing Address - Fax:
Practice Address - Street 1:11011 Q ST STE 101C
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-3700
Practice Address - Country:US
Practice Address - Phone:402-697-5121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider