Individual
KIMBERLY PETETIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 SW RAMSEY AVE, GRANTS PASS, OR 97527-5535
(541) 472-7810
Mailing address
520 SW RAMSEY AVE, GRANTS PASS, OR 97527-5535
(541) 472-7810
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10047790
OR
Other
Enumeration date
07/03/2025
Last updated
07/22/2025
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