Individual
COLLEEN FLORA PETULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
9695 N. FIORELLA ST., PRESCOTT VALLEY, AZ 86315
(702) 460-9009
Mailing address
9695 N. FIORELLA ST., PRESCOTT VALLEY, AZ 86315
(928) 312-2030
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
59225
NM
363LF0000X
Family Nurse Practitioner
Primary
RNP227728
AZ
Other
Enumeration date
08/29/2019
Last updated
12/09/2020
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