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1174248405
SAMANTHA NICOLE PETTY
STERLING, IL
NPI
1174248405
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: IL 209.026134)
Enumeration Date
2022-10-10
Last Update Date
2022-10-10
Business Address
SAMANTHA NICOLE PETTY PMHNP
1808 19TH AVE
STERLING, IL 61081-1676
Phone number: 815-718-2344
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Mailing Address
SAMANTHA NICOLE PETTY PMHNP
1808 19TH AVE
STERLING, IL 61081-1676
Phone number: 815-718-2344
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