Individual
SHELLEY L PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6190 CONGRESS DR, WEST BEND, WI 53095-8103
(262) 675-6390
Mailing address
724 N EVANS ST, SHEBOYGAN, WI 53081-3746
(262) 388-5381
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
97651-030
WI
Other
Enumeration date
01/30/2007
Last updated
08/14/2023
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