Individual
EMILY BROOKE PETTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1118 ROSS CLARK CIR STE 100, DOTHAN, AL 36301-3023
(334) 794-1148
Mailing address
1118 ROSS CLARK CIR STE 100, DOTHAN, AL 36301-3023
(334) 794-1148
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AG0114029
AL
Other
Enumeration date
09/29/2014
Last updated
09/30/2014
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