Individual
JESSE PETRUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2220 N DRUID HILLS RD NE, ATLANTA, GA 30329-3117
(404) 785-5437
Mailing address
7804 LAKE VISTA CT UNIT 204, LAKEWOOD RANCH, FL 34202-2125
(631) 495-3780
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN327584
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN-NP327584
GA
Other
Enumeration date
11/21/2022
Last updated
10/29/2025
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