| Doctor Name: | MRS. LINDA ANN PETTIT |
| NPI Number: | 1063593523 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CLINICAL NURSE SPECI |
| License Number: | NS03049 |
| Business Practice Address: | 180 E Spring Valley Rd B Centerville, OH - 454583803 |
| Business Phone Number: | 9372911351 |
| Business Fax Number: | 9372911719 |
| Mailing Address: | 180 E Spring Valley Rd, Ste B CENTERVILLE |
| State: | OH |
| Postal Code: | 454583803 |
| Phone Number: | 9372911351 |
| Fax Number: | 9372911719 |
| NPI Enumeration Date: | 10/18/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0809X |
| License Number: | NS03049 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |