Provider Demographics
NPI:1821893728
Name:PETERSEN, KARLEE KEENE (RN)
Entity type:Individual
Prefix:
First Name:KARLEE
Middle Name:KEENE
Last Name:PETERSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KARLEE
Other - Middle Name:KEENE
Other - Last Name:JOSEPHSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9154 GRAND SUNBURST CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-3266
Mailing Address - Country:US
Mailing Address - Phone:360-818-8242
Mailing Address - Fax:
Practice Address - Street 1:250 PILOT RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-3542
Practice Address - Country:US
Practice Address - Phone:702-982-3292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV881618163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health