Katherine Lee Petkovich, DNP, RN, CPNP-PC
Nurse Practitioner, Pediatrics in Mesa, AZ. Individual provider (NPI-1).
NPI number1841968898
StatusActive
Last updated in NPPESJun 2, 2025
Details
- NPI
- 1841968898
- Entity type
- Individual (NPI-1)
- Name
- Katherine Lee Petkovich
- Credential
- DNP, RN, CPNP-PC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 3, 2021
- Certification date
- Jun 2, 2025
- Last updated
- Jun 2, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | 323837 | AZ | Yes |
| 163W00000X | Registered Nurse | RN215094 | AZ |
Practice location
2017 E Adobe StMesa, AZ 85213-6740
Phone 480-244-5373
Mailing address
2017 E Adobe StMesa, AZ 85213-6740
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All 29 Pediatric Nurse Practitioner providers in Mesa · All 13,507 providers in Mesa
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