Pettibone, Anne Marie

Pettibone, Anne Marie is an individual health care provider with primary practice located at 975 Sereno Dr , Vallejo CA 94589-2441. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Pettibone, Anne Marie can be contacted via phone (707) 651-4742.

Contact Information

Primary practice address
975 Sereno Dr Vallejo CA 94589-2441
Phone: (707) 651-4742
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 3322 California

Profile Details

NPI number 1063576080
LBN Legal business name Pettibone, Anne Marie
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2006
Last updated Jan 3rd, 2022 - about 2 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 1063576080 NPPES
California Other RN4506780 MEDI-CAL RENDERING NUMBER

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