Individual
ADDIE PETTIFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3901 PINE LAKE RD STE 410, LINCOLN, NE 68516-5415
(402) 483-8700
(402) 483-8733
Mailing address
3901 PINE LAKE RD STE 410, LINCOLN, NE 68516-5415
(402) 483-8700
(402) 483-8733
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
95092
NE
Other
Enumeration date
07/01/2026
Last updated
07/01/2026
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