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Individual

MICHAEL GLENN PETTY

Active
Find providers by NPI
Individual

MICHAEL GLENN PETTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN, ACNS-BC, CCNS

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
095570
MN
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
71
MN
364SC0200X
Critical Care Medicine Clinical Nurse Specialist
71
MN

Other

Enumeration date
04/20/2020
Last updated
04/20/2020
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