Individual
JANA PETRA
Active
Individual
JANA PETRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01051788A
IN
207L00000X
Anesthesiology Physician
Primary
ME103317
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000586017
ANTHEM PROVIDER NUMBER
IN
05
—
200365040
—
IN
Enumeration date
11/29/2006
Last updated
11/17/2021
Update your record
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