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Individual
MR. WILLIAM R PETRICONE III
Active
Individual
MR. WILLIAM R PETRICONE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1123512
TX
364S00000X
Clinical Nurse Specialist
1123512
TX
364SG0600X
Gerontology Clinical Nurse Specialist
Primary
1123512
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
03/03/2025
Last updated
09/29/2025
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