Individual
KELLY N PETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1001 SAM PERRY BLVD, FREDERICKSBURG, VA 22401-4453
(800) 394-4445
(706) 955-0720
Mailing address
23955 MILL COVE RD, CALIFORNIA, MD 20619-3576
(301) 737-1430
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0001191107
VA
367500000X
Certified Registered Nurse Anesthetist
127961
MD
Other
Enumeration date
09/27/2006
Last updated
05/02/2008
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