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Individual

MS. PATTI JO PETERSON-BALLIET

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN CPNP

Contact information

Practice address
4137 N 108TH AVE, PHOENIX, AZ 85037-5459
(623) 772-7842
Mailing address
4137 N 108TH AVE, PHOENIX, AZ 85037-5459
(623) 877-7337

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
20030451
AZ
363LP0200X
Pediatric Nurse Practitioner
Primary
AP3772
AZ

Other

Enumeration date
09/02/2006
Last updated
07/12/2021
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