Individual provider · Type 1 NPI

Kaitlyn Rene' Petty

Student in an Organized Health Care Education/Training Program · Springfield, MO

NPI number 1922702174 Active

Practice location

901 S National Ave # PROF160
Springfield, MO 65897-0027

Call (417) 836-5000 Map

Mailing address

504 SW Nelson Dr
Grain Valley, MO 64029-9042

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1922702174

Kaitlyn Rene' Petty's National Provider Identifier is 1922702174, issued on Mar 29, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Springfield, MO. The record was last updated on Jun 16, 2023.