Individual
SHAWNA MARIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
512 S 28TH AVE, WAUSAU, WI 54401-4147
(715) 847-2021
Mailing address
2164 MEADOWBROOK WAY, WAUSAU, WI 54403-9329
(715) 573-1679
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1612233
WI
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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