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Individual

KATHERINE LEE PETKOVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, RN, CPNP-PC

Contact information

Practice address
2017 E ADOBE ST, MESA, AZ 85213-6740
(480) 244-5373
Mailing address
2017 E ADOBE ST, MESA, AZ 85213-6740

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN215094
AZ
363LP0200X
Pediatric Nurse Practitioner
Primary
323837
AZ

Other

Enumeration date
09/03/2021
Last updated
06/02/2025
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