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

SHANE TYLER PETTIS

Active Sole Proprietor

SHANE TYLER PETTIS is a Peer Specialist healthcare provider located in AMHERST, New York. NPI 1386214807 is currently active in the NPPES registry. Verify at CMS.

Peer Specialist · AMHERST, NY

Registration Details

NPI Number
1386214807
Provider Type
Individual
Gender
Male
NPI Issued
Jun 28, 2021 (5.1707980560124 yrs)
Last Updated
Jun 28, 2021
Sole Proprietor
Yes

Practice Information

Address
1412 SWEET HOME RD STE 3-5
AMHERST, NY, 142282795
Browse NY providers · Browse ZIP 14228
Phone
7165891411
Fax
7162763051
Primary Specialty
Peer Specialist
175T00000X

Other Peer Specialist Providers in AMHERST, NY

Name Credential NPI
MERCEDES BUSBY 1174140545
CHERYL GEARTZ 1922744358
TANISHA BROOKS 1043090202
ALISHA STEPHANIE CLINE 1306616438
MRS. JOANNE ROSE MARIE WALES 1568223519
NATALIE PEREZ 1760367726
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.