Individual
NICOLE PETRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7440 W FRONTAGE RD, SHAWNEE MISSION, KS 66203-4670
(913) 236-6455
Mailing address
10906 W 169TH TER, OVERLAND PARK, KS 66221-7954
(913) 206-2196
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
04-50947
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2021
Last updated
06/17/2025
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