Individual
BRENNA J. PETRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2199 N MERRIT CRK LOOP, COEUR D ALENE, ID 83814-4949
(208) 665-7546
Mailing address
2199 N MERRIT CRK LOOP, COEUR D ALENE, ID 83814-4949
(208) 665-7546
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN134782
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
488480
—
AZ
Enumeration date
11/24/2009
Last updated
07/27/2023
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