Provider Demographics
NPI:1881610871
Name:SHAULL-NORMAN, PEGGY SUE (RN, MSN, CS, ANP,MBA)
Entity type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:SUE
Last Name:SHAULL-NORMAN
Suffix:
Gender:F
Credentials:RN, MSN, CS, ANP,MBA
Other - Prefix:
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Mailing Address - Street 1:5500 ARMSTRONG RD
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-1014
Mailing Address - Country:US
Mailing Address - Phone:269-966-5600
Mailing Address - Fax:269-660-6003
Practice Address - Street 1:5500 ARMSTRONG RD
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-1014
Practice Address - Country:US
Practice Address - Phone:269-966-5600
Practice Address - Fax:269-660-6003
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704117878363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health