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NPI Code Detail

MEDICARE: KARA DEANNE PETTY FNP-C

MEDICARE:   KARA DEANNE PETTY  FNP-C
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
1363L00000XNurse PractitionerAP132483TX

General Provider Information

NPI Number : 1083943450
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARA DEANNE PETTY FNP-C
Provider Business Mailing Address
First Line : 400 N SAINT PAUL ST STE 1140
Second Line :
City : DALLAS
State : TX
Zip : 75201-3145
Country : US
Telephone Number : 972-449-0540
Fax Number : 972-449-0550
Provider Business Practice Location Address
First Line : 400 N SAINT PAUL ST STE 1140
Second Line :
City : DALLAS
State : TX
Zip : 75201-3145
Country : US
Telephone Number : 972-449-0540
Fax Number : 972-449-0550
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2009
Last Update Date : 07/21/2022

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Directions to “ KARA DEANNE PETTY FNP-C” Practice Location

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