Individual
ERIN PETTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT DEPT, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2024026753
MO
363LP0200X
Pediatric Nurse Practitioner
53-83362-061
KS
Other
Enumeration date
07/22/2024
Last updated
08/02/2024
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