Individual provider · Type 1 NPI
Katherine Marcela Pettyjohn, FNP-BC
Primary Care Clinic/Center · Modesto, CA
NPI number
1568945285
Active
Practice location
1409 Lecourbe Ct
Modesto, CA 95356-8905
Fax (209) 409-8239
Mailing address
3880 Colma Ave
Merced, CA 95348-8719
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | 95009952 (CA) |
Primary Care Clinic/Center: Definition to come...
Another provider at this address
About NPI 1568945285
Katherine Marcela Pettyjohn, FNP-BC's National Provider Identifier is 1568945285, issued on Sep 9, 2018. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Modesto, CA. The record was last updated on Sep 9, 2018.