| NPI | 1528519519 |
|---|---|
| Former Name | NICHOLE MICHELE PETRIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95010881) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95010881) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NV 815623) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NV 815623) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO 0998004) | |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2023-04-17 |