Gloria Petty, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN314273 Issued in GA

Practice address

705 Town Blvd NE
Brookhaven, GA 30319-3011

Phone

(770) 799-6028

NPI assigned

Mar 21, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1003676552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 N POINT PKWY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300228808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 TOWN BLVD NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193011",
            "telephone_number": "770-799-6028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4205 N Point Pkwy",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300228808",
            "country_code": "US",
            "telephone_number": "770-664-5550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTY",
        "first_name": "GLORIA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN314273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Neurosurgery Associates at Children'S, LLC
• Michelle Peppers, RBT
• Kelly Perdomo, NP-C
• Kelly Peterson, LCSW
• Kennedy Petit, RBT
• Joseph Allen Pfeffer, LCSW
• Kevin Roy Pharris, M.D., M.P.H.
• Rashadia Phillips, RBT
• Physical Therapy and Performance Training LLC
• Eleanor Abigail Pickard, LPC

• Registered Nurse in Brookhaven, GA
• Providers in Brookhaven, GA by specialty
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.