Individual
KATHY PETRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1825 ROCKBRIDGE RD STE 15B, STONE MOUNTAIN, GA 30087-3306
(470) 444-3134
(470) 276-4370
Mailing address
PO BOX 740013, ATLANTA, GA 30374-0013
(312) 733-9730
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704271968
MI
363LA2200X
Adult Health Nurse Practitioner
Primary
RN314101
GA
Other
Enumeration date
07/31/2013
Last updated
02/02/2023
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