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General NPI Number Information
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NPI Number | 1497233985
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Entity Type | Individual
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Provider Name | PAMELA PETRO NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/06/2018
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Last Update Date | 08/06/2018
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Provider Practice Location Address
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Address Line | 36001 EUCLID AVE STE C19
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City | WILLOUGHBY
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State | OH
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Zip | 44094-4651
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Country | US
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Telephone | 440-946-0053
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Fax | 440-946-1812
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Provider Business Mailing Address
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Address Line | 15258 MUNN RD
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City | NEWBURY
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State | OH
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Zip | 44065-9551
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Country | US
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Telephone | 440-668-8860
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Fax |
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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 | APRN.CNP.023297
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License Number State | OH
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