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General NPI Number Information
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NPI Number | 1366622185
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Entity Type | Individual
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Provider Name | CLARE PETTY APRN, BC
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Gender | Female
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 300 E 8TH ST STE 121
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City | MARIETTA
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State | OH
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Zip | 45750-3379
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Country | US
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Telephone | 740-374-7464
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Fax | 740-374-1562
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Provider Business Mailing Address
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Address Line | 416 COLEGATE DR BLDG 3
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City | MARIETTA
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State | OH
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Zip | 45750-9549
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Country | US
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Telephone | 740-374-3526
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Fax | 740-374-3165
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 46395
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | COA.10940.NP
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License Number State | OH
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