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General NPI Number Information
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NPI Number | 1518662824
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Entity Type | Individual
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Provider Name | VICTORIA LYNN PETTY NNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/04/2023
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 777 BANNOCK ST
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City | DENVER
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State | CO
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Zip | 80204-4597
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Country | US
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Telephone | 303-436-4949
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Fax | 303-436-6328
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Provider Business Mailing Address
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Address Line | 777 BANNOCK ST
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City | DENVER
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State | CO
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Zip | 80204-4597
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Country | US
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Telephone | 303-436-4949
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Fax | 303-436-6328
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0034521
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | 104656728
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | APN.100338-NP
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | APN.1000338-NP
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License Number State | CO
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