Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shawna Marie Peterson

Individual provider Nurse Practitioner · NPI 1700693397

Shawna Marie Peterson is a Nurse Practitioner in Wausau, Wisconsin. Qualified in 2024, 2 years ago. Practices with ENT and Allergy Associates SC, a 25-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
2
Licensed in
WI
In the registry since
2024
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Practice location Address checks out

512 S 28th Ave
Wausau, WI 54401-4147
Phone: (715) 847-2021
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 1612233 (WI)

Record details

NPI number1700693397
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 17, 2024
Last updated in NPPESDecember 17, 2024
Certification dateDecember 17, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Ent And Allergy Associates Sc — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Wausau