Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lidia Timofeenko Petersen

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1245857952

Lidia Timofeenko Petersen is a Nurse Practitioner in Las Vegas, Nevada. Qualified in 2020, 6 years ago. Practices with State of Nevada, a 57-clinician group and accepts Medicare assignment. Licensed in Idaho and Nevada.

Years since qualifying
6
Licensed in
ID, NV
In the registry since
2020
Specialties on file
3
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

972 Sugar Springs Dr
Las Vegas, NV 89110-2936
Phone: (208) 410-3048
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 835379 (NV)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 53260 (ID)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence TEMP53260 (ID)

Record details

NPI number1245857952
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 29, 2020
Last updated in NPPESSeptember 6, 2022
Certification dateSeptember 6, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice State Of Nevada — 57 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Las Vegas