Provider Demographics
NPI:1710784731
Name:PETERS, ANDREW G
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:G
Last Name:PETERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 E LAUX DR
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-2722
Mailing Address - Country:US
Mailing Address - Phone:402-705-1591
Mailing Address - Fax:
Practice Address - Street 1:2908 E LAUX DR
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-2722
Practice Address - Country:US
Practice Address - Phone:402-705-1591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant