Active NPI
Debra Elaine Pettit, RN
- Registered Nurse
- Greeley, CO
National Provider Identifier
1013904994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 125188
- Practice address
- 1555 N 17TH Ave
Greeley, CO 80631-9117 - Phone
- (970) 304-6420
- NPI assigned
- Oct 5, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 125188 | CO | Primary |
Addresses
Primary practice location
1555 N 17TH Ave
Greeley, CO 80631-9117
Mailing address
14800 County Road 88
Pierce, CO 80650-9309
Phone (970) 834-1217
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60708832 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125188 | CO | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1013904994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14800 COUNTY ROAD 88",
"city": "PIERCE",
"state": "CO",
"postal_code": "806509309",
"telephone_number": "970-834-1217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1555 N 17TH AVE",
"city": "GREELEY",
"state": "CO",
"postal_code": "806319117",
"telephone_number": "970-304-6420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTIT",
"first_name": "DEBRA",
"middle_name": "ELAINE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-05",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CO",
"license": "125188",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "60708832",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.