Individual
SHAUNA PETTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
7450 ALBERT RD FL 2, BRANDYWINE, MD 20613-3035
(301) 888-2233
(301) 888-9133
Mailing address
11207 BARNSWALLOW PL APT E, WALDORF, MD 20603-4837
(414) 748-7776
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R215472
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
444563500
—
MD
Enumeration date
11/09/2009
Last updated
02/16/2023
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