Doctor Name: | TOSHA PETTIT |
NPI Number: | 1346675949 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.P.N |
License Number: | 71200 |
Business Practice Address: | 457 Hannings Ln Martin, TN - 382373307 |
Business Phone Number: | 7315873854 |
Business Fax Number: | 7316608739 |
Mailing Address: | 1804 Highway 45 Byp, Suite 604 JACKSON |
State: | TN |
Postal Code: | 383054436 |
Phone Number: | 7316607971 |
Fax Number: | 7316608739 |
NPI Enumeration Date: | 09/13/2013 |
NPI Last Update Date: | 09/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | 71200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |