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

Shane Peterson

Individual provider Driver · NPI 1972181246

Shane Peterson is a Driver in Mora, Minnesota. Practices as a sole proprietor. Registered with an NPI since 2021.

In the registry since
2021
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Practice location Address checks out

325 Watkins St
Mora, MN 55051-1553
Phone: (320) 438-4493
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Driver (primary) Taxonomy 172A00000X

Record details

NPI number1972181246
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 30, 2021
Last updated in NPPESMarch 30, 2021
Certification dateMarch 30, 2021