Individual provider · Type 1 NPI
Latisha Renee Petty
Primary Care Nurse Practitioner · Petersburg, VA
NPI number
1245199280
Active
Practice location
1429 Halifax St
Petersburg, VA 23803-5933
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | 0024195858 (VA) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1245199280
Latisha Renee Petty's National Provider Identifier is 1245199280, issued on Jan 16, 2026. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Petersburg, VA. The record was last updated on Jan 16, 2026.