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Individual
MRS. JENNIFER R PETKOS
Active
Individual
MRS. JENNIFER R PETKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
335842
NY
363LF0000X
Family Nurse Practitioner
Primary
F335842-1
NY
Other
Enumeration date
07/09/2009
Last updated
03/13/2019
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