| Doctor Name: | MRS. SARAH LEE PETERSON |
| NPI Number: | 1215260831 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 159129-030 |
| Business Practice Address: | 253 Forest St Campbellsport, WI - 530102734 |
| Business Phone Number: | 9202511409 |
| Business Fax Number: | |
| Mailing Address: | 253 Forest St, CAMPBELLSPORT |
| State: | WI |
| Postal Code: | 530102734 |
| Phone Number: | 9202511409 |
| Fax Number: | |
| NPI Enumeration Date: | 09/14/2009 |
| NPI Last Update Date: | 09/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0000X |
| License Number: | 159129-030 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | General Practice |
| Taxonomy Definition: | |