Individual provider Active NPI

Nanette Burfield Pettry, CRNP

  • Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1326062845
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP133927 Issued in TX
Practice address
4801 Alberta Ave
El Paso, TX 79905-2707
Phone
(915) 215-5200
Fax
(915) 215-8640
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP133927 TX Primary
Nurse Practitioner 363L00000X 1-056480 AL

Addresses

Primary practice location

4801 Alberta Ave
El Paso, TX 79905-2707

Mailing address

5130 Gateway Blvd E
El Paso, TX 79905-1608
Phone (915) 215-4480

Other practice location 1

513 Brookwood Blvd
Suite 401
Birmingham, AL 35209-6862
Phone (205) 870-0256 ext. 142

Other practice location 2

125 W Hague Rd
El Paso, TX 79902-5814
Phone (915) 532-1620

Other identifiers 1

IdentifierTypeStateIssuer
51530417OtherALBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170719003142 TX Practitioner - Nurse Practitioner 9032167531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 215-5400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-056480ALMDNurse Practitioner
AP133927TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center CurrentSince May 25, 2017 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince May 25, 2017 Accepting new patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
BHS Specialty Network Inc Past Accepting new patients
Jefferson Clinic, P.C. Past Accepting new patients

Locations

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1326062845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 GATEWAY BLVD E",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799051608",
            "telephone_number": "915-215-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 ALBERTA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052707",
            "telephone_number": "915-215-5200",
            "fax_number": "915-215-8640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "513 Brookwood Blvd",
            "address_2": "Suite 401",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352096862",
            "country_code": "US",
            "telephone_number": "205-870-0256 x142",
            "fax_number": "205-870-7107",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 W Hague Rd",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799025814",
            "country_code": "US",
            "telephone_number": "915-532-1620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTRY",
        "first_name": "NANETTE",
        "middle_name": "BURFIELD",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP133927",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-056480",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51530417",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.