Christina Brueckner Pettit, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

11042 Issued in SC

Practice address

1300 Long Grove Dr
Target Pharmacy T-1529
Mount Pleasant, SC 29464-9462

Phone

(843) 388-8769

NPI assigned

Jun 10, 2011

Last updated

Jun 10, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1760777411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 LONG GROVE DR",
            "address_2": "TARGET PHARMACY T-1529",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294649462",
            "telephone_number": "843-388-8769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 LONG GROVE DR",
            "address_2": "TARGET PHARMACY T-1529",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294649462",
            "telephone_number": "843-388-8769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "CHRISTINA",
        "middle_name": "BRUECKNER",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-10",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "11042",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2004009928",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baley Petersen, O.D.
• Andrea Michelle Peterson, M.D.
• Ann M. Peterson, APRN-BC
• Tricia Peterson, DPT
• Alyssa Petry, WHNP-BC
• Mark C Pettus, M.D.
• PG Vision (Pearle Vision)
• Pharmonix Lab, LP
• Pamela Phelan
• Philip E Melchers Dentistry DMD LLC (Old Mt Pleasant Dentistry)

• Pharmacist in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Pharmacist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; 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.