Individual provider · Type 1 NPI
Colleen Flora Petullo, NP-C
Family Nurse Practitioner · Prescott Valley, AZ
NPI number
1790333003
Active
Practice location
9695 N. Fiorella St.
Prescott Valley, AZ 86315
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 59225 (NM) |
| Family Nurse Practitioner Primary | 363LF0000X | RNP227728 (AZ) |
Family Nurse Practitioner: Definition to come...
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About NPI 1790333003
Colleen Flora Petullo, NP-C's National Provider Identifier is 1790333003, issued on Aug 29, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Prescott Valley, AZ. The record was last updated on Dec 9, 2020.