Individual
HANNAH JO PETTIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2410 SUSANNAH ST, JOHNSON CITY, TN 37601-1748
(423) 282-9011
(423) 282-0035
Mailing address
1909 JAMESTOWN RD, JOHNSON CITY, TN 37604-7640
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5062
TN
363AS0400X
Surgical Physician Assistant
Primary
5062
TN
Other
Enumeration date
06/20/2022
Last updated
06/20/2022
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