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Contact Information

THUY L PETERSEN, PAC
1300 METROPOLITAN AVE
LEAVENWORTH, KS66048
 Phone: 913-682-8700
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for THUY L PETERSEN · (Female)

NPI Number 1285969667
Status Active
Credentials PAC
Entity Individual
Enumeration date 10/02/2009
Last updated 07/11/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 1089316
  • MO Other 1089316 MISSOURI LICENSE NUMBER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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