Active NPI
Debra W. Petro, APRN
- Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
- Dover, DE
National Provider Identifier
1265582670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
- License
- LE-0000183
- Practice address
- 121 W Loockerman St
Dover, DE 19904-7325 - Phone
- (302) 674-1397
- NPI assigned
- Jan 11, 2007
- 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 |
|---|---|---|---|---|
| Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0807X | LE-0000183 | DE | Primary |
Addresses
Primary practice location
121 W Loockerman St
Dover, DE 19904-7325
Mailing address
117 Dungarvan Drive
Middletown, DE 19709
Phone (302) 690-2872
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LE-0000183 | DE | MD | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333324800000",
"number": "1265582670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 DUNGARVAN DRIVE",
"city": "MIDDLETOWN",
"state": "DE",
"postal_code": "19709",
"telephone_number": "302-690-2872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 W LOOCKERMAN ST",
"city": "DOVER",
"state": "DE",
"postal_code": "199047325",
"telephone_number": "302-674-1397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRO",
"first_name": "DEBRA",
"middle_name": "W.",
"name_prefix": "Mrs.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-11",
"last_updated": "2012-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "364SP0807X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
"state": "DE",
"license": "LE-0000183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dover, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.