Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JACQUELINE BERNADINE PETRAVAGE, M.D.
ActiveDR. JACQUELINE BERNADINE PETRAVAGE, M.D. is a Psychiatry healthcare provider located in SALT LAKE CITY, Utah. NPI 1104861079 is currently active in the NPPES registry. Verify at CMS.
Psychiatry · SALT LAKE CITY, UT
Registration Details
- NPI Number
- 1104861079
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 17, 2006 (20.199780483102 yrs)
- Last Updated
- Jul 8, 2007
- License
-
1664161205 (UT)
Practice Information
- Address
-
VETERAN'S HOSPITAL, 500 FOOTHILL BLVDBLDG 47SALT LAKE CITY, UT, 841480001Browse UT providers · Browse ZIP 84148
- Phone
- 8015821565
- Fax
- 8015842544
- Primary Specialty
-
Psychiatry
2084P0800X
Other Psychiatry Providers in SALT LAKE CITY, UT
| Name | Credential | NPI |
|---|---|---|
| DR. ROBERT D BIRCH | DO | 1245220805 |
| MICHAELA SIEMES MOHR | MD | 1326038985 |
| NUSRAT AHMED | M.D. | 1497739387 |
| DR. MARK RAPAPORT | M.D. | 1194709998 |
| DONNA KAY PHILIPPI | D.O. | 1881670982 |
| DR. CHARLOTTE ELAINE GANT | M.D. | 1518944818 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.