FAWNE PETERSON MT NPI 1053785931

NPI Information

  • NPI: 1053785931
  • Provider Name: FAWNE PETERSON, MT
  • Classification: Massage Therapist - 225700000X
  • Entity Type: Individual
  • Address: 44191 PLYMOUTH OAKS BLVD
    SUITE 400
    PLYMOUTH, MI
    ZIP 48170
  • Phone: (734) 259-7103

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NPI Details

Fawne Peterson, MT is a massage therapist in Plymouth, MI. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. Fawne Peterson, MT NPI is 1053785931. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

44191 PLYMOUTH OAKS BLVD
SUITE 400
PLYMOUTH, MI
ZIP 48170-530
Phone: (734) 259-7103

The enumeration date for this NPI number is 11/16/2015 and was last updated on 11/16/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1225700000XMassage Therapist7501002781MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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