Organization
PETRIE GERIATRIC HEALTHCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAIRE A PETRIE ARNP (DIRECTOR)
(850) 516-1919
Entity
Organization
Contact information
Practice address
1286 FERNANDO CIR, CANTONMENT, FL 32533-5737
(850) 516-1919
Mailing address
P.O. BOX 37277, PENSACOLA, FL 32526
(850) 623-2948
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
ARNP1222292
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A39
BLUE CROSS BLUE SHIELD
FL
05
—
306540500
—
FL
Enumeration date
04/28/2009
Last updated
04/30/2010
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