Marilyn Martin Petro, WHNP-RX AUTH

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

685722 Issued in TX

Practice address

1141 Keller Pkwy
Suite a
Keller, TX 76248-1627

Phone

(817) 741-2601

Fax

(817) 745-2601

NPI assigned

Mar 29, 2010

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

Other identifiers 1

Other names 1

• Mrs. Marti Petro Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269820800000",
    "number": "1336464783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 KELLER PKWY",
            "address_2": "SUITE A",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762481627",
            "telephone_number": "817-741-2601",
            "fax_number": "817-745-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 KELLER PKWY",
            "address_2": "SUITE A",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762481627",
            "telephone_number": "817-741-2601",
            "fax_number": "817-745-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRO",
        "first_name": "MARILYN",
        "middle_name": "MARTIN",
        "name_prefix": "Mrs.",
        "credential": "WHNP-RX AUTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-29",
        "last_updated": "2010-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "TX",
            "license": "685722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1578768701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTI",
            "last_name": "PETRO",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Obstetrics & Gynecology Nurse Practitioner in Keller, TX
• Providers in Keller, TX by specialty
• Obstetrics & Gynecology Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; 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.