| NPI | 1083267959 |
|---|---|
| Doing Business As | SHELLY LYNN PETERS |
| Entity Type | Organization |
| Authorized Contact | SHELLY LYNN PETERS Owner/Nurse Practitioner 315-362-2540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2019-08-20 |