Individual
NIKKI PETTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1098 S MAYO TRL, SUITE 103, PIKEVILLE, KY 41501-1546
(606) 218-2205
(606) 432-0336
Mailing address
PO BOX 432, PIKEVILLE, KY 41502-0432
(606) 218-2205
(606) 432-0336
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
923068
KY
Other
Enumeration date
06/21/2016
Last updated
06/21/2016
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