Petrillo, Amy M.

Petrillo, Amy M. is an individual health care provider with primary practice located at 1302 W Main St Ste. A, Louisville OH 44641-1114. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Petrillo, Amy M. can be contacted via phone (330) 875-5544.

Contact Information

Primary practice address
1302 W Main St Ste. A Louisville OH 44641-1114
Fax: (330) 875-8150
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X COA 13890-NP Ohio

Profile Details

NPI number 1174874846
LBN Legal business name Petrillo, Amy M.
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2012
Last updated Jun 21st, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174874846 NPPES
Ohio MEDICAID 0073609

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