Doctor Name: | MS. SHARON ANN PETERSON |
NPI Number: | 1952677312 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | R111583-9 |
Business Practice Address: | 2980 Rice St Little Canada, MN - 551132230 |
Business Phone Number: | 6514884655 |
Business Fax Number: | 6514884656 |
Mailing Address: | 2980 Rice St, LITTLE CANADA |
State: | MN |
Postal Code: | 551132230 |
Phone Number: | 6514884655 |
Fax Number: | 6514884656 |
NPI Enumeration Date: | 03/29/2012 |
NPI Last Update Date: | 03/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WH0200X |
License Number: | R111583-9 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Home Health |
Taxonomy Definition: |