NPI 1124649157

Desirae Pettit

Practitioner Nurse's Aide Terryville, CT

Practice location

Address: 33 Beach Ave, Terryville, CT 06786-6317
Phone: (203) 592-4593

Registered specialties

Nurse's Aide Primary

Nursing Service Related Providers Taxonomy 376K00000X Licence NA91285300 (CT)

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Registry record

NPI: 1124649157
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Apr 2020
Record last updated: 30 Apr 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.