Shirley Marie Petersen in Appleton - Licensed Practical Nurse
Shirley Marie Petersen - NPI 1689680084
Shirley Marie Petersen is a Licensed Practical Nurse in Appleton, Wisconsin. Shirley Marie Petersen practices all healthcare services and medical treatments related to Licensed Practical Nurse. The NPI Number for Shirley Marie Petersen is 1689680084. The last update date is 2007-07-08.
Shirley Marie Petersen's current location address is 10 Tri Park Way, Appleton, Wisconsin. You can contact this provider via phone number 9208310070 and fax number 9208317939. The mailing address for Shirley Marie Petersen is 10 Tri Park Way, Appleton, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shirley Marie Petersen |
|---|---|
| Address | 10 Tri Park Way, Appleton, Wisconsin |
| Phone Number | 9208310070 |
| Fax Number | 9208317939 |
| Sole Proprietor | Y |
| Credentials | LPN |
NPI Number Detail
| NPI Number | 1689680084 |
|---|---|
| Provider Enumeration Date | 2006-07-31 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 10 Tri Park Way |
|---|---|
| City | Appleton |
| State | Wisconsin (WI) |
| Post Code | 549141658 |
| Phone Number | 9208310070 |
| Fax Number | 9208317939 |
Provider's Primary Taxonomy Detail
| Speciality | Licensed Practical Nurse |
|---|---|
| Taxonomy | 164W00000X |
| Licence No | 16432-031 |
|
Definition: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job r |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 16432-031 | WI | LPN |
Post Comment/ Review Below
What is the Shirley Marie Petersen's 1689680084?
The Shirley Marie Petersen's NPI (National Provider Identifier) Number is 1689680084. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Shirley Marie Petersen?
The Shirley Marie Petersen is physically situated at 10 Tri Park Way, in the city of Appleton, state of WI, with the postal code 549141658.
What is Shirley Marie Petersen's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Shirley Marie Petersen is Licensed Practical Nurse, and the taxonomy code that categorizes this field of expertise is 164W00000X.
On what date did the Shirley Marie Petersen receive the assignment of its 1689680084 from the Centers for Medicare & Medicaid Services?
The Shirley Marie Petersen was issued its 1689680084 by the Centers for Medicare & Medicaid Services on 2006-07-31.
When was the information pertaining to Shirley Marie Petersen most recently updated or revised?
The details related to Shirley Marie Petersen, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.