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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KELLY RAE PETTIGREW, OPTICIAN LICENSE FL

Active

KELLY RAE PETTIGREW, OPTICIAN LICENSE FL is a Optometrist healthcare provider located in DULCE, New Mexico. NPI 1164917373 is currently active in the NPPES registry. Verify at CMS.

Optometrist · DULCE, NM

Registration Details

NPI Number
1164917373
Provider Type
Individual
Gender
Female
NPI Issued
Jun 29, 2018 (7.9418243239821 yrs)
Last Updated
Jun 29, 2018
License
DO5748 (FL)

Practice Information

Address
505 NORTH MUNDO
DULCE, NM, 87528
Browse NM providers · Browse ZIP 87528
Phone
5757593291
Primary Specialty
Optometrist
152W00000X

Other Optometrist Providers in DULCE, NM

Name Credential NPI
MARICELA BONILLA O.D. 1265460851
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.