Petra T Dotson, NBC-HWC
Individual provider Active NPI Health & Wellness Coach · Versailles, KY
NPI 1750168639 · NPPES record last updated Sep 13, 2023
Key facts
- NPI
- 1750168639
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Health & Wellness Coach 171400000X
- License
- A-3795356 (KY)
- Practice address
- 519 Southland Dr
Versailles, KY 40383-1483 - Phone
- (859) 213-0378
- NPI assigned
- Sep 13, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-3795356 | KY | MD | Health & Wellness Coach |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | A-3795356 | KY | Yes |
Addresses
Primary practice location
519 Southland Dr
Versailles, KY 40383-1483
Mailing address
519 Southland Dr
Versailles, KY 40383-1483
Phone (859) 213-0378
Other providers in Versailles, KY
- Deschner Medical Services LLC Deboss Neurology & Pain Clinic
- Deschner Medical Services LLC Deboss Neurology & Pain Clinic
- Ashton Rose Dezeeuw
- Gabriela Diaz
- Divine Vision Developement Center Inc.
- Douglas E. Vick, DO M. Tamarin Vick, DO
- Dr Richard Drayer, Optometrist
- Richard Drayer
- Chastity Gwen Drobena
- Eric Edwards
All providers in Versailles, KY · Health & Wellness Coach in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.