Individual
LATISHA RENEE PETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1429 HALIFAX ST, PETERSBURG, VA 23803-5933
(540) 748-6048
Mailing address
1429 HALIFAX ST, PETERSBURG, VA 23803-5933
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
0024195858
VA
Other
Enumeration date
01/16/2026
Last updated
01/16/2026
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