Individual
CHRISTINE PETTIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
45 ASHLEY AVE, MIDDLETOWN, NY 10940-1912
(845) 326-8045
Mailing address
45 ASHLEY AVE, MIDDLETOWN, NY 10940-1912
(845) 326-8045
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401177
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
4417
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
01
—
AA63393334
MEDICARE PTAN
SC
Enumeration date
10/31/2008
Last updated
08/23/2011
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