Individual
MARY KATHRYN PETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNS
Contact information
Practice address
2700 W NORFOLK AVE, NORFOLK, NE 68701-4438
(402) 371-4880
Mailing address
2700 W NORFOLK AVE, NORFOLK, NE 68701-4438
(402) 371-4880
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
27389
NE
364S00000X
Clinical Nurse Specialist
Primary
114001
NE
Other
Enumeration date
11/03/2011
Last updated
11/17/2011
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