Gloria Petty, RN
Registered Nurse in Brookhaven, GA. Individual provider (NPI-1).
NPI number1003676552
StatusActive
Last updated in NPPESMar 21, 2024
Details
- NPI
- 1003676552
- Entity type
- Individual (NPI-1)
- Name
- Gloria Petty
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 21, 2024
- Certification date
- Mar 21, 2024
- Last updated
- Mar 21, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | RN314273 | GA | Yes |
Practice location
705 Town Blvd NeBrookhaven, GA 30319-3011
Phone 770-799-6028
Mailing address
4205 N Point PkwyAlpharetta, GA 30022-8808
Other practice locations
4205 N Point Pkwy
Alpharetta, GA 30022-8808
Alpharetta, GA 30022-8808
Phone 770-664-5550
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 6 Registered Nurse providers in Brookhaven · All 830 providers in Brookhaven
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