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Shirley Marie Petersen, LPN
Licensed Practical Nurse in Appleton, Wisconsin
NPI 1689680084

Shirley Marie Petersen is a Licensed Practical Nurse based in Greenleaf, WI. Shirley Marie Petersen practices in Appleton, WI and has the professional credentials of LPN. The NPI Number for Shirley Marie Petersen is 1689680084 and holds a License No. 16432-031 (Wisconsin).

The current practice location address for Shirley Marie Petersen is 10 Tri Park Way, Appleton, WI and can be reached out via phone at 920-831-0070 and via fax at 920-831-7939.

Location: 10 Tri Park Way, Appleton, WI, 54126-9666
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1689680084
Provider Name
Shirley Marie Petersen
Credential
LPN
Provider Entity Type
Individual
Gender
Female
Address
10 Tri Park Way, Appleton, WI, 54126-9666
Phone Number
920-831-0070
Fax Number
920-831-7939
Provider Enumeration Date
07/31/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
16432-031 01 WI LPN
institution
Provider Business Practice Location Address Details
Address
10 Tri Park Way
City
Appleton
State
Wisconsin
Zip
54914-1658
Phone Number
920-831-0070
Fax Number
920-831-7939
person
Provider Business Mailing Address Details
Address
10 Tri Park Way
City
Appleton
State
Wisconsin
Zip
54914-1658
Phone Number
920-831-0070
Fax Number
920-831-7939
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
16432-031 (Wisconsin)
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 responsibilities vary among the states.
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