Individual
MRS. DIANE RENEE PETRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.-BC
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3430
(816) 234-3421
Mailing address
504 BIRCHWOOD CT, RAYMORE, MO 64083-8551
(816) 699-1741
(816) 761-1188
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2007018736
MO
Other
Enumeration date
08/03/2012
Last updated
08/03/2012
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