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Individual
MARIA C PETTY
Active
Individual
MARIA C PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
004979
CT
363LG0600X
Gerontology Nurse Practitioner
RN2290435
MA
363LP2300X
Primary Care Nurse Practitioner
Primary
NP020610
OH
Other
Enumeration date
11/15/2011
Last updated
07/08/2021
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