Debbie Ann Petellat

Primary specialty

Nurse's AideTaxonomy code 376K00000X

Practice address

316 NE 2ND St Lot 11
Crystal River, FL 34429-4251

Phone

(352) 422-2547

Fax

(352) 563-5450

NPI assigned

Dec 21, 2007

Last updated

Dec 21, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198195200000",
    "number": "1295919520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 NE 2ND ST LOT 11",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344294251",
            "telephone_number": "352-422-2547",
            "fax_number": "352-563-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 NE 2ND ST LOT 11",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344294251",
            "telephone_number": "352-422-2547",
            "fax_number": "352-563-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETELLAT",
        "first_name": "DEBBIE",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-21",
        "last_updated": "2007-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse's Aide in Crystal River, FL
• Providers in Crystal River, FL by specialty
• Nurse's Aide in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2007; 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.