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Individual
MR. RICHARD K PETTIT
Active
Individual
MR. RICHARD K PETTIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RNFA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
438088
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
438088
REGISTERED NURSE LICENSE
CA
Enumeration date
09/24/2006
Last updated
07/08/2007
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