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Individual

LISA PETTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
618 HOSPITAL RD, TAPPAHANNOCK, VA 22560-5000
(804) 443-8628
Mailing address
P.O. BOX 411, MONTROSS, VA 22520
(443) 966-5191

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0024177799
VA

Other

Enumeration date
08/11/2019
Last updated
01/27/2022
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