Individual
ERIKA PETTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1509 STATE ST, LA PORTE, IN 46350-3115
(219) 326-5700
Mailing address
1509 STATE ST, LA PORTE, IN 46350-3115
(219) 326-1234
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
1093343170
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
LA
Other
Enumeration date
04/01/2020
Last updated
08/26/2024
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