Individual
PETER KAORU SHIBUYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN CPNP
Contact information
Practice address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2916
(202) 476-5000
Mailing address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2916
(202) 476-5000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN 65724
DC
363LP0200X
Pediatric Nurse Practitioner
Primary
0024124961
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010237432
—
VA
05
—
037472500
—
DC
05
—
520703700
—
MD
Enumeration date
12/21/2006
Last updated
02/08/2011
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