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Individual

MRS. MISTY C PETRAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
102 ASTOR ST, WELLFORD, SC 29385
(864) 439-5338
Mailing address
102 ASTOR ST, WELLFORD, SC 29385-9622
(864) 439-5338

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
106862
SC
163WC0200X
Critical Care Medicine Registered Nurse
106862
SC
163WS0200X
School Registered Nurse
106862
SC
363LF0000X
Family Nurse Practitioner
Primary
21997
SC

Other

Enumeration date
04/26/2013
Last updated
11/12/2019
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