Individual provider · Type 1 NPI

Shalena Peterson, PA-C

Medical Physician Assistant · Prescott, AZ

NPI number 1083965651 Active

Practice location

3120 Clearwater Dr
Prescott, AZ 86305-7131

Fax (928) 771-0434

Mailing address

PO Box 10880
Prescott, AZ 86304-0880

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X8594 (AZ)

Medical Physician Assistant: Definition to come...

14 other providers at this address

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About NPI 1083965651

Shalena Peterson, PA-C's National Provider Identifier is 1083965651, issued on Sep 24, 2012. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Prescott, AZ. The record was last updated on Feb 17, 2025.