NELSON J P PETTEY (Credential# 1046299) is licensed (Advanced Practice Registered Nurse) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2012. The license expiration date date is April 30, 2013. The license status is INACTIVE.
NELSON J P PETTEY is licensed with the Department of Consumer Protection of Connecticut. The credential number is #12.004909. The credential type is advanced practice registered nurse. The effective date is May 1, 2012. The expiration date is April 30, 2013. The business address is 12439 W Engelmann Dr, Boise, ID 83713-1419. The current status is inactive.
Licensee Name | NELSON J P PETTEY |
Credential ID | 1046299 |
Credential Number | 12.004909 |
Credential Type | Advanced Practice Registered Nurse |
Business Address |
12439 W Engelmann Dr Boise ID 83713-1419 |
Business Type | INDIVIDUAL |
Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
Issue Date | 2012-01-03 |
Effective Date | 2012-05-01 |
Expiration Date | 2013-04-30 |
Refresh Date | 2014-07-24 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
893599 | 10.090629 | Registered Nurse | 2009-09-02 | 2012-05-01 - 2013-04-30 | INACTIVE |
1058486 | CSP.0052187 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2012-04-05 | 2012-04-05 - 2013-02-28 | INACTIVE |
893600 | 10.090527-TEMP | Registered Nurse - Temporary | 2009-06-26 | 2009-06-26 - 2009-10-24 | INACTIVE |
Street Address | 12439 W ENGELMANN DR |
City | BOISE |
State | ID |
Zip Code | 83713-1419 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Pinnacle Engineers Inc | 12552 W Exec Dr Suite #b, Boise, ID 83713 | Professional Engineering Corporation | 2005-01-18 ~ 2006-01-18 |
Patrick D Van Kleek | 12552 W Executive Dr Ste B, Boise, ID 83713 | Professional Engineer | 2005-02-01 ~ 2006-01-31 |
Corey M Elliot | 10749 West Susan, Boise, ID 83713 | Registered Nurse | 2000-04-13 ~ 2001-02-28 |
Betty M Weatherby · Lawrence | 3730 Covered Wagon, Boise, ID 83713 | Registered Nurse | ~ 1997-01-31 |
Rachel Bowman | 12325 Ramblin Rose Drive, Boise, ID 83713 | Licensed Practical Nurse | 2004-01-29 ~ 2005-03-31 |
Joseph S Gabrielsen | 5401 N. Hickory Glen Place, Boise, ID 83713 | Emergency Medical Technician | 2003-03-25 ~ 2005-04-01 |
Jennifer M Ripley | 5712 N Wellspring Way, Boise, ID 83713-1304 | Registered Nurse | 2014-03-05 ~ 2015-03-31 |
Richard Radnovich | 4850 N Rosepoint Way Ste 100, Boise, ID 83713-5262 | Physician/surgeon | ~ |
Brent M Kallam | 12500 W Ardyce Dr, Boise, ID 83713-5818 | Paramedic | 2010-09-15 ~ 2011-02-28 |
Nutri-vet | 549 N Dupont Ave, Boise, ID 83713-5906 | Commercial Feed | 2017-01-01 ~ 2017-12-31 |
Find all Licenses in zip 83713 |
City | BOISE |
Zip Code | 83713 |
License Type | Advanced Practice Registered Nurse |
License Type + County | Advanced Practice Registered Nurse + BOISE |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Viorika Nelson | 69 Burnham Rd, Greenfield, MA 01301-1113 | Advanced Practice Registered Nurse | 2020-06-08 ~ 2020-08-31 |
Jennifer L Nelson Aprn | 24 Reynolds Ave, Branford, CT 06405-4525 | Advanced Practice Registered Nurse | 2020-03-01 ~ 2021-02-28 |
Kathryn A Nelson | 679 Raymond Hill Rd, Uncasville, CT 06382 | Advanced Practice Registered Nurse | 2020-06-01 ~ 2021-05-31 |
Susan E Nelson | 1361 Rosemary Ct, Hastings, MN 55033-2443 | Advanced Practice Registered Nurse | 2017-06-01 ~ 2018-05-31 |
Sonia M Nelson-brown | 7605 Nw 18 Th Place, Margate, FL 33063 | Advanced Practice Registered Nurse | 2020-02-01 ~ 2021-01-31 |
Kim E Cotnoir | Po Box 656, Johnson, VT 05656-0656 | Advanced Practice Registered Nurse | 2020-08-01 ~ 2021-07-31 |
Maury G Barrett | 185 Massachusetts Ave Apt 803, Boston, MA 02115-3035 | Advanced Practice Registered Nurse | ~ |
Nicole M Frost | Po Box 25, Poquonock, CT 06064 | Advanced Practice Registered Nurse | 2016-11-01 ~ 2017-10-31 |
Cynthia A Ely | 30 Deepwood Rd, Wilton, CT 06897-4201 | Advanced Practice Registered Nurse | 2019-12-01 ~ 2020-11-30 |
Kristen Shoar | 56 Fountain Rd, Wales, MA 01081-9511 | Advanced Practice Registered Nurse | ~ |
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Data Provider | Connecticut Department of Consumer Protection |
Jurisdiction | Connecticut |
Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).