Provider Demographics
NPI:1134145899
Name:CHRISTENSEN-PETERSON, SHAUNA H (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAUNA
Middle Name:H
Last Name:CHRISTENSEN-PETERSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SHAUNA
Other - Middle Name:
Other - Last Name:CHRISTENSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:505 EAST BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203
Mailing Address - Country:US
Mailing Address - Phone:704-347-2888
Mailing Address - Fax:704-347-0068
Practice Address - Street 1:505 EAST BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203
Practice Address - Country:US
Practice Address - Phone:704-347-2888
Practice Address - Fax:704-347-0068
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2120111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2449122Medicaid
U56074Medicare UPIN
NC2449122Medicare PIN