Johanna Christine Pettrey in Clovis - Family
Johanna Christine Pettrey - NPI 1265413447
Johanna Christine Pettrey is a Family in Clovis, New Mexico. Johanna Christine Pettrey practices all healthcare services and medical treatments related to Family. The NPI Number for Johanna Christine Pettrey is 1265413447. The last update date is 2022-07-21.
Johanna Christine Pettrey's current location address is 912 W 21st St, Clovis, New Mexico. You can contact this provider via phone number 5759359000 and fax number 5759351002. The mailing address for Johanna Christine Pettrey is 912 W 21st St, Clovis, New Mexico. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Johanna Christine Pettrey |
|---|---|
| Address | 912 W 21st St, Clovis, New Mexico |
| Phone Number | 5759359000 |
| Fax Number | 5759351002 |
| Sole Proprietor | N |
| Credentials | FNP-BC |
NPI Number Detail
| NPI Number | 1265413447 |
|---|---|
| Provider Enumeration Date | 2005-11-07 |
| Last Updated Date | 2022-07-21 |
Provider Mailing Address Detail
| Address | 912 W 21st St |
|---|---|
| City | Clovis |
| State | New Mexico (NM) |
| Post Code | 881014154 |
| Phone Number | 5759359000 |
| Fax Number | 5759351002 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | 1144582 |
|
Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| G7157 | NM | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Johanna Christine Pettrey by the Centers for Medicare & Medicaid Services (CMS)?
The Johanna Christine Pettrey has been assigned the NPI (National Provider Identifier) 1265413447. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete physical location address of Johanna Christine Pettrey?
The Johanna Christine Pettrey is physically situated at 912 W 21St St, in the city of Clovis, state of NM, with the postal code 881014154.
When was the Johanna Christine Pettrey's 1265413447 issued?
The Johanna Christine Pettrey's 1265413447 was issued on 2005-11-07.
When was the Johanna Christine Pettrey's information last updated?
The Johanna Christine Pettrey's information was last updated on 2022-07-21.
When was the information pertaining to Johanna Christine Pettrey most recently updated or revised?
The details related to Johanna Christine Pettrey, including its address, specialty, and other relevant information, were last updated or revised on 2022-07-21.