Individual
SAMONE PETTWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
855 LAKEWOOD RD, WATERBURY, CT 06704-5408
(860) 793-3500
Mailing address
492 EAST ST APT 13, PLAINVILLE, CT 06062-3272
(203) 988-7366
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
40373
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1231
N/A
CT
Enumeration date
05/20/2021
Last updated
05/20/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us