Peterson, Shanna B

Peterson, Shanna B is an individual health care provider with primary practice located at 1201 N Main Ave Suite 3, Erwin TN 37650-9102. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Peterson, Shanna B can be contacted via phone (423) 743-3440.

Contact Information

Primary practice address
1201 N Main Ave Suite 3 Erwin TN 37650-9102
Phone: (423) 743-3440
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APN11999 Tennessee

Profile Details

NPI number 1295781045
LBN Legal business name Peterson, Shanna B
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2006
Last updated Oct 21st, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295781045 NPPES
Tennessee Other 4131091 BCBST
Tennessee MEDICAID 3643493 BCBST
Tennessee Other 4131091 BCBST

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