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Individual
MS. JANELLE MARIE PETINGA
Active
Individual
MS. JANELLE MARIE PETINGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
2009006582
WI
363LP2300X
Primary Care Nurse Practitioner
Primary
4113-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336453315
—
WI
Enumeration date
08/02/2010
Last updated
02/04/2022
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