Individual
MRS. ANGELA PATRICE PETTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1050 W PERIMETER RD, ANDREWS AFB, MD 20762-6601
(240) 857-8509
Mailing address
18 FARMINGTON RD W, ACCOKEEK, MD 20607-9767
(301) 292-3959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R153416
MD
367500000X
Certified Registered Nurse Anesthetist
Primary
0024169705
VA
Other
Enumeration date
01/30/2008
Last updated
12/06/2011
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