Pettigrew, Jennifer Ingle

Pettigrew, Jennifer Ingle is an individual health care provider with primary practice located at 151 N Sunrise Ave Ste. 611, Roseville CA 95661-2924. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is her primary health care specialty. Pettigrew, Jennifer Ingle can be contacted via phone (916) 789-1505.

Contact Information

Primary practice address
151 N Sunrise Ave Ste. 611 Roseville CA 95661-2924
Phone: (916) 789-1505
Fax: (916) 789-1513
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X M1784 Texas
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X M1784 Texas
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X A107629 California

Profile Details

NPI number 1922115088
LBN Legal business name Pettigrew, Jennifer Ingle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2006
Last updated Aug 12th, 2009 - about 16 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 1922115088 NPPES
Texas MEDICAID 176965505
Texas Other 8AC882

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