Individual provider · Type 1 NPI
Maria C. Petty, NURSE PRACTITIONER
Primary Care Nurse Practitioner · Willoughby, OH
NPI number
1114204419
Active
Practice location
35000 Kaiser Ct
Willoughby, OH 44094-3382
Fax (216) 229-6017
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 004979 (CT) |
| Primary Care Nurse Practitioner Primary | 363LP2300X | NP020610 (OH) |
| Gerontology Nurse Practitioner | 363LG0600X | RN2290435 (MA) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1114204419
Maria C. Petty, NURSE PRACTITIONER's National Provider Identifier is 1114204419, issued on Nov 15, 2011. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Willoughby, OH. The record was last updated on Jul 8, 2021.