MRS. EBONY SHANDREKA PETERSON (NPI# 1396293841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396293841 |
| Entity Type | Individual |
| Full Name | MRS. EBONY SHANDREKA PETERSON |
| Credential | FNP-BC |
| Practice Address |
10001 S Eastern Ave Ste 108 Henderson NV 89052-3908 |
| Mailing Address |
400 N Stephanie St Ste 300 Henderson NV 89014-6692 |
| Practice Telephone | 7029523444 |
| Practice Fax Number | 7029523494 |
| Mailing Telephone | 7029523356 |
| Mailing Fax Number | 7029523364 |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2020-03-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 821513 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R42316 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
10001 S EASTERN AVE STE 108 |
| City | HENDERSON |
| State | NV |
| Zip Code | 89052-3908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679662688 | Ghulam Hossein Kashef | Internal Medicine | 10001 S Eastern Ave Ste 108, Henderson, NV 89052 | 2006-10-11 |
| 1922571199 | Katelyne May Atijera | Nurse Practitioner | 10001 S Eastern Ave Ste 108, Henderson, NV 89052-3908 | 2019-01-09 |
| 1245698117 | Samiyah M Hoodbhoy | Physician Assistant | 10001 S Eastern Ave Ste 108, Henderson, NV 89052 | 2016-02-05 |
| 1457624751 | Pamela Gay O'neil | Nurse Practitioner | 10001 S Eastern Ave Ste 108, Henderson, NV 89052 | 2012-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740889112 | Nathan Michael Nasternak | Physical Therapist | 750 Coronado Center Drive, Suite 140, 2212, Henderson, NV 89052 | 2020-10-18 |
| 1558987180 | Braxton Chad Storm | Counselor | 2990 W. Sundridge Heights Pkwy, Suite #140, Henderson, NV 89052 | 2020-06-19 |
| 1558996546 | The Eye Doctor At St. Rose LLC | Eyewear Supplier (Equipment, not the service) | 2645 St. Rose Parkway, Suite C-110, Henderson, NV 89052 | 2020-03-10 |
| 1770138521 | Quinn Dentists of St. Rose, PC | Dentist | 3519 St Rose Parkway, Ste 110, Henderson, NV 89052 | 2019-08-08 |
| 1346802568 | Rickie Kwong Chin Jr. | Optometrist | 695 S. Green Valley Pkwy, Henderson, NV 89052 | 2019-07-08 |
| 1134695646 | Nu Smiles, LLC | Clinic/Center | 2810 W. Horizon Ridge Parkway, Suite #110, Henderson, NV 89052 | 2018-10-23 |
| 1003393497 | Katherine Lee Villarreal | Physical Therapist | 2930 W Horizon Pkwy, Suite 205, Henderson, NV 89052 | 2018-07-27 |
| 1790281889 | Vicki Lorraine Schmidt | Nurse Practitioner | 2900 W. Horizon Ridge Pkwy, Suite 101, Henderson, NV 89052 | 2018-04-05 |
| 1326566969 | Shelby Schiller | Social Worker | 3051 W Horizon Ridge Pkwy Ste 104a, Henderson, NV 89052 | 2017-09-04 |
| 1639696826 | Pca Ventures, LLC | Technician | 2656 Soda Butte Court, Henderson, NV 89052 | 2017-08-28 |
| Find all providers in zip 89052 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083227870 | Raven Nicole Pirtle | Nurse Practitioner | 1245 Glenshiel Dr, Henderson, KY 42420-2529 | 2020-08-31 |
| 1811509359 | Kristi Lynn Navarette | Nurse Practitioner | 3058 Hushed Sonnet Ave, Henderson, NV 89044-0558 | 2020-08-17 |
| 1275143711 | Kristyn Cisilino | Nurse Practitioner | 2556 Chateau Clermont St, Henderson, NV 89044-0459 | 2020-08-07 |
| 1972113363 | Rini Susan Mathews | Nurse Practitioner | 3396 Dalmore St, Henderson, NV 89044-1722 | 2020-07-31 |
| 1033735014 | Savinder Kaur Virk | Nurse Practitioner | 10747 Shasta Glow Ct, Henderson, NV 89052-8691 | 2020-06-24 |
| 1811517022 | D Ana Curtis | Nurse Practitioner | 815 Chameleon Star Ave, Henderson, NV 89015-2411 | 2020-04-17 |
| 1275169013 | Joyce Carlos Damiano | Nurse Practitioner | 2839 Saint Rose Pkwy Ste 130, Henderson, NV 89052-4849 | 2020-03-12 |
| 1568008878 | Oliver Torrefranca | Nurse Practitioner | 910 Monte Etna Ave, Henderson, NV 89012-2654 | 2019-11-21 |
| 1568006864 | Melissa Ann Ridella | Nurse Practitioner | 1748 W Horizon Ridge Pkwy, Henderson, NV 89012-4833 | 2019-10-30 |
| 1245881317 | Edith Borgert | Nurse Practitioner | 3039 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-4193 | 2019-09-20 |
| Find all providers in HENDERSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.