Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. KATHERINE MARCELA PETTYJOHN, FNP-BC
Active Sole ProprietorMRS. KATHERINE MARCELA PETTYJOHN, FNP-BC is a Primary Care Clinic healthcare provider located in MODESTO, California. NPI 1568945285 is currently active in the NPPES registry. Verify at CMS.
Primary Care Clinic · MODESTO, CA
Registration Details
- NPI Number
- 1568945285
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 9, 2018 (7.7447576097581 yrs)
- Last Updated
- Sep 9, 2018
- License
-
95009952 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1409 LECOURBE CTMODESTO, CA, 953568905Browse CA providers · Browse ZIP 95356
- Phone
- 2094098239
- Fax
- 2094098239
- Primary Specialty
-
Primary Care Clinic
261QP2300X
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.