Individual
ANGELA CHRISTINE PETTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1 MERAMEC BLUFFS DR, BALLWIN, MO 63021-3309
(636) 923-2399
Mailing address
40 MERAMEC TRAIL DR, BALLWIN, MO 63021-3331
(636) 923-2399
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2003026650
MO
Other
Enumeration date
05/03/2022
Last updated
05/03/2022
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