Individual
RYAN PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
6379 SILVER LAKE RD, LINDEN, MI 48451-8706
(810) 735-7847
(810) 735-7159
Mailing address
3495 S CENTER RD, BURTON, MI 48519-1455
(810) 424-2011
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704289644
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902331598
—
MI
Enumeration date
04/21/2017
Last updated
07/21/2022
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