Individual
KATHRYN PETRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
118 NORMAN DORMINY DR, FITZGERALD, GA 31750-8858
(229) 423-9561
Mailing address
118 NORMAN DORMINY DR, FITZGERALD, GA 31750-8858
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN203692
GA
Other
Enumeration date
12/29/2014
Last updated
12/29/2014
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