Individual
MRS. KATHERINE MARCELA PETTYJOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1409 LECOURBE CT, MODESTO, CA 95356-8905
(209) 409-8239
(209) 409-8239
Mailing address
3880 COLMA AVE, MERCED, CA 95348-8719
(209) 617-4647
(209) 409-8239
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
95009952
CA
Other
Enumeration date
09/09/2018
Last updated
09/09/2018
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