Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Ebony Shandreka Peterson, FNP-BC, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1396293841

Mrs. Ebony Shandreka Peterson, FNP-BC, PMHNP-BC is a Nurse Practitioner in Las Vegas, Nevada. Qualified in 2016, 10 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Nevada.

Years since qualifying
10
Licensed in
NV
In the registry since
2016
Specialties on file
3
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

2575 S Cimarron Rd Ste 104
Las Vegas, NV 89117-2682
Phone: (725) 712-4625
Fax: (725) 262-5536
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 821513 (NV)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 821513 (NV)
Nurse Practitioner Taxonomy 363L00000X · Licence 821513 (NV)

Record details

NPI number1396293841
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC , PMHNP-BC
Sole proprietorYes
NPI enumeratedSeptember 13, 2016
Last updated in NPPESOctober 21, 2025
Certification dateOctober 21, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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