Individual
KELLI A PETRONIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-9222
(757) 668-7568
Mailing address
601 CHILDRENS LN, NORFOLK, VA 23507-1971
(757) 668-9222
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101233589
VA
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
0101233589
VA
208000000X
Pediatrics Physician
0101233589
VA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
0101233589
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006739105
—
VA
05
—
1010661080001
—
PA
05
—
403654900
—
MD
05
—
89066C4
—
NC
Enumeration date
05/27/2006
Last updated
06/28/2023
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