Individual
HEATHER PETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8060 KNUE RD STE 110, INDIANAPOLIS, IN 46250-1938
(317) 842-7435
Mailing address
1153 N WHITCOMB AVE, INDIANAPOLIS, IN 46224-6704
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
48-01-02-01744
IN
Other
Enumeration date
07/12/2007
Last updated
07/12/2007
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