Individual
REBEKAH PAIGE PETRIELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6047 TYVOLA GLEN CIR, CHARLOTTE, NC 28217-6431
(443) 383-9300
(855) 866-8710
Mailing address
1230 26TH AVE NE, HICKORY, NC 28601-7611
(828) 962-8481
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1151725
TX
363L00000X
Nurse Practitioner
Primary
5015845
NC
363L00000X
Nurse Practitioner
APN.28370
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366197402
—
NC
01
—
NNK757A
MEDICARE
NC
01
—
Q00382662
RAILROAD MEDICARE
NC
Enumeration date
02/17/2022
Last updated
01/24/2025
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