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Individual

JANA PETELLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 442-0711
Mailing address
365 MONTAUK AVE, NEW LONDON, CT 06320
(603) 609-6819

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
082357-23
NH
367500000X
Certified Registered Nurse Anesthetist
204167
CT
367500000X
Certified Registered Nurse Anesthetist
Primary
4030919
KY
367500000X
Certified Registered Nurse Anesthetist
RNA183052
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3122430
NH
Enumeration date
06/08/2016
Last updated
01/24/2025
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