Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 3009326 | KY |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 3009326 | KY |
NPI | 1285029926 |
---|---|
Provider Name | Mrs. Rhonda Jean Petty |
First Address | Lexington, KY 40536-0001 |
Second Address | Lexington, KY 40536-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2015 |
Last Update Date | 13/07/2020 |