| Doctor Name: | SHANNON PETERSON |
| NPI Number: | 1215345210 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DNP, ARNP |
| License Number: | H112768 |
| Business Practice Address: | 1501 E 10th St Atlantic, IA - 500221936 |
| Business Phone Number: | 7122432850 |
| Business Fax Number: | 7122437423 |
| Mailing Address: | 1501 E 10th St, ATLANTIC |
| State: | IA |
| Postal Code: | 500221936 |
| Phone Number: | 7122432850 |
| Fax Number: | 7122437423 |
| NPI Enumeration Date: | 07/23/2014 |
| NPI Last Update Date: | 06/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | H112768 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |