Individual
EMILY COLLEEN PETITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
401 N BROADWAY ST, SIDNEY KIMMEL COMPREHENSIVE CANCER CENTER, BALTIMORE, MD 21287-0019
(410) 955-8893
Mailing address
3002 HUNTING RIDGE DR, OWINGS MILLS, MD 21117-4950
(410) 356-8016
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R163713
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023692600
—
MD
Enumeration date
03/23/2009
Last updated
10/27/2009
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