Nancy Hall Pettit, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001808 Issued in IA

Practice address

320 McKenzie Ave
Suite 201
Council Bluffs, IA 51503

Phone

(712) 256-6100

NPI assigned

Jul 27, 2018

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

State licenses

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1972080331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29824 290TH ST",
            "address_2": "PO BOX 405",
            "city": "NEOLA",
            "state": "IA",
            "postal_code": "515590405",
            "telephone_number": "712-485-2693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 MCKENZIE AVE",
            "address_2": "SUITE 201",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "51503",
            "telephone_number": "712-256-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6510 Sorensen Pkwy",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681522138",
            "country_code": "US",
            "telephone_number": "402-390-9700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "NANCY",
        "middle_name": "HALL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-27",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Marie Petersen, PHARMD
• Danelle Catherine Peterson, PA-C
• Liberty Peterson
• Aunna Petitt, LMHC
• Michael Todd Pettit, RPH
• Kelee Sun Lou Peyton, MD
• Rachel E Pfeifer, LMSW
• Sheryl Leann Pfeiler, PHARMD, RP
• Pharmacy Express Services Inc
• Pharmacy Express Services Inc.

• Physician Assistant in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; 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.