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NPI Code Detail

MEDICARE: EMMA PETTY DNP, RN, FNP-BC, APN

MEDICARE: EMMA PETTY DNP, RN, FNP-BC, APN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner8842-33WI
2363L00000XNurse Practitioner8842WI
3163WG0000XGeneral Practice Registered Nurse195659-30WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447732110
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMMA PETTY DNP, RN, FNP-BC, APN
Provider Business Mailing Address
First Line : 2808 W JUNEAU AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53208
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11333 W NATIONAL AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53227-3111
Country : US
Telephone Number : 414-329-4979
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2018
Last Update Date : 01/16/2026

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