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NPI Profile for MARYKAY PETGES in POPLAR GROVE, IL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pediatrics |
163WP0200X |
| NPI Number | 1295938645 |
|
| Status | Active | |
| Credentials | RN (Registered Nurse) | |
| Entity | Individual | |
| Enumeration date | 06/05/2007 | |
| Last updated | 07/08/2007 - About 19 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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MARYKAY PETGES
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MARYKAY PETGES, RN