Organization
WAYSHOWER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE ANN PETERSON PMHNP-BC (SOLE MEMBER LLC OWNER)
(530) 262-7025
Entity
Organization
Contact information
Practice address
21449 ROUGHOUT RD, REDDING, CA 96003-8209
(530) 262-7025
(949) 553-3834
Mailing address
16590 HEITMAN RD, COTTONWOOD, CA 96022-8004
(530) 262-7025
(949) 553-3834
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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