Individual
ELIZABETH A PETTEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
301 MED TECH PKWY STE 240, JOHNSON CITY, TN 37604-2641
(423) 794-5520
(423) 282-6940
Mailing address
PO BOX 3889, JOHNSON CITY, TN 37602-3889
(423) 794-2457
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
33931
TN
363LF0000X
Family Nurse Practitioner
0024185836
VA
Other
Enumeration date
03/29/2023
Last updated
05/08/2023
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