Individual
DAPHNE N PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
314 S 5TH ST, GADSDEN, AL 35901-4224
(256) 547-9500
(256) 547-3039
Mailing address
PO BOX 660685, BIRMINGHAM, AL 35266-0685
(205) 979-5882
(205) 979-1248
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-054576
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51511358
BCBS OF AL
AL
Enumeration date
09/14/2006
Last updated
07/09/2007
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