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Organization

PETERSON FAMILY HEALTHCARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHANNA B PETERSON FNP (SOLE MEMBER)
(423) 341-0629
Entity
Organization

Contact information

Practice address
1201 N MAIN AVE STE 3, ERWIN, TN 37650-9102
(423) 341-0629
Mailing address
PO BOX 716, ERWIN, TN 37650-0716
(423) 341-0629

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN11999
TN

Other

Enumeration date
09/10/2010
Last updated
09/10/2010
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