Individual
NICOLE LYNN PETCKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
H100 EMORY UNIVERSITY HOSPITAL 1364 CLIFTON ROAD NE, ATLANTA, GA 30322-0001
(009) 340-4727
Mailing address
1280 LEAR LN APT 14, DE PERE, WI 54115-7262
(920) 883-8740
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/01/2022
Last updated
04/01/2022
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