Provider Demographics
NPI:1083177794
Name:SHIFTING FOCUS
Entity Type:Organization
Organization Name:SHIFTING FOCUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ELYSIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:320-385-1010
Mailing Address - Street 1:408 GREAT OAK DR # 408A
Mailing Address - Street 2:
Mailing Address - City:WAITE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:56387-2504
Mailing Address - Country:US
Mailing Address - Phone:320-385-1010
Mailing Address - Fax:320-295-7906
Practice Address - Street 1:408 GREAT OAK DR # 408A
Practice Address - Street 2:
Practice Address - City:WAITE PARK
Practice Address - State:MN
Practice Address - Zip Code:56387-2504
Practice Address - Country:US
Practice Address - Phone:320-385-1010
Practice Address - Fax:320-295-7906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty