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General NPI Number Information
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NPI Number | 1497415277
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Entity Type | Individual
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Provider Name | CATHY PETTIS DNP, APRN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/21/2021
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 8 S BROADVIEW ST., STE E & F
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City | GREENBRIER
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State | AR
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Zip | 72058-9601
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Country | US
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Telephone | 501-679-0232
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Fax | 833-373-0348
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Provider Business Mailing Address
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Address Line | 2720 CENTER ST
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City | LITTLE ROCK
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State | AR
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Zip | 72206-3126
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Country | US
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Telephone | 501-920-3883
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Fax | 501-916-9449
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 218452
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License Number State | AR
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