SHANE PETERSON
NPI 1972181246
Driver in Mora, MN
About Shane Peterson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHANE PETERSON (NPI 1972181246) is an individual driver provider in Mora, Minnesota and active in the NPI registry since March 2021.
NPPES Registry Identity
Specialties & Licenses
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Shane Peterson's NPI number?
The NPI number for Shane Peterson is 1972181246. It was assigned to this individual provider in the NPPES registry on March 30, 2021.
Where is Shane Peterson located?
Shane Peterson practices at 325 Watkins St, Mora, MN 55051. The listed phone number is (320) 438-4493.
What is Shane Peterson's specialty?
The primary specialty registered for this NPI is Driver with taxonomy code 172A00000X.
When was this NPI record last updated?
The NPPES record for Shane Peterson was last updated on March 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Shane Peterson · NPI 1972181246
Driver provider in Mora, Minnesota. Individual provider, active in the CMS NPPES registry since March 30, 2021.
## Identity
- **NPI:** 1972181246 (Entity type: Individual)
- **Enumerated:** March 30, 2021
- **Primary specialty:** Driver · taxonomy 172A00000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 325 WATKINS ST, Mora, MN 55051-1553
- **Phone:** (320) 438-4493
## Record status
- **NPPES last updated:** March 30, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1972181246) · Data from the CMS NPPES public registry.