JUDITH PETRIN (NPI# 1437146339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437146339 |
| Entity Type | Individual |
| Full Name | JUDITH PETRIN |
| Credential | APRN |
| Practice Address |
12600 Creekside Ln Suite 7 Fort Myers FL 33919-3353 |
| Mailing Address |
Po Box 2147 Fort Myers FL 33902-2147 |
| Practice Telephone | 2393439220 |
| Practice Fax Number | 2393439231 |
| Mailing Telephone | 2393439220 |
| Mailing Fax Number | 2393439231 |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2020-10-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SG0600X |
Clinical Nurse Specialist Specialization: Gerontology |
APRN1196972 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 302429600 | 05 |
| Street Address |
12600 CREEKSIDE LN SUITE 7 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33919-3353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902898471 | Michael P. Shain | Psychologist | 12600 Creekside Ln, Suite 7, Fort Myers, FL 33919 | 2005-08-19 |
| 1063834653 | Tyson Hutchison | Nurse Practitioner | 12600 Creekside Ln, Suite 6, Fort Myers, FL 33919 | 2014-01-16 |
| 1598044745 | Cristina Maria Larrazaleta Fajardo | Internal Medicine | 12600 Creekside Ln, Suite 7, Fort Myers, FL 33919-3353 | 2011-08-05 |
| 1760791107 | Amie Nichole Peterson | Nurse Practitioner | 12600 Creekside Ln, Suite 6, Fort Myers, FL 33919-3353 | 2010-10-04 |
| 1972756005 | Tanja Mani | Psychologist | 12600 Creekside Ln, Suite 6, Fort Myers, FL 33919 | 2008-11-03 |
| 1457551400 | Neurology Associates of Lee County | Specialist | 12600 Creekside Ln, Suite 7, Fort Myers, FL 33919-3353 | 2007-07-18 |
| 1003970336 | Denise M Mcpherson | Nurse Practitioner | 12600 Creekside Ln, Suite 7, Fort Myers, FL 33919-3353 | 2006-12-21 |
| 1568415438 | Cathleen L Zerbe | Nurse Practitioner | 12600 Creekside Ln, Suite 6, Fort Myers, FL 33919-3353 | 2006-05-19 |
| 1669425732 | Mary Lewis | Nurse Practitioner | 12600 Creekside Ln, Suite 6, Fort Myers, FL 33919-3353 | 2006-05-18 |
| 1649263724 | Lmr Imaging | Radiology | 12600 Creekside Ln, Fort Myers, FL 33919-3353 | 2005-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073145942 | Patricia June Briand | Registered Nurse | 4309 Mariner Way #307, Fort Myers, FL 33919 | 2020-02-10 |
| 1629556840 | The Onyx Counseling Center, LLC | Social Worker | 6361 Presidential Ct Ste 101, Fort Myers, FL 33919 | 2018-07-31 |
| 1366980187 | My Precious Kids Therapy Center Inc | Community/Behavioral Health | 4755 Summerlin Road, Suite #4, Fort Myers, FL 33919 | 2017-02-01 |
| 1811342397 | Kimberly Regenesis | Substance Abuse Rehabilitation Facility | 8695 College Parkway, Suite 2080, Ft Myers, FL 33919 | 2016-05-03 |
| 1689030207 | Balance for All, Inc. | Acupuncturist | 6238 Presidential Ct., Ste 6, Fort Myers, FL 33919 | 2016-01-12 |
| 1902275217 | Kelly Jean Overton | Physical Therapist | 6341 Whiskey Creek Drive, Fort Myers, FL 33919 | 2015-09-16 |
| 1508125311 | Charles Clark Dugan IIi | Chiropractor | 6309 Corporate Court, Suite 110, Fort Myers, FL 33919 | 2012-05-14 |
| 1659641231 | Dasha Bich Le | Pharmacist | 9629 Bay Harbor Cir., Apt. 201, Fort Myers, FL 33919 | 2012-01-12 |
| 1164792602 | Gail Lee Rathbun | Nurse Practitioner | 6311 S. Pointe Blvd., Fort Meyers, FL 33919 | 2011-12-30 |
| 1871878173 | Scott Kozlowski | Behavioral Analyst | 5335 Shalley Cir., Ft. Myers, FL 33919 | 2011-10-18 |
| Find all providers in zip 33919 | ||||
| Taxonomy Code | 364SG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861923179 | Ana Maria Class | Clinical Nurse Specialist | 12857 Sawgrass Pine Cir, Orlando, FL 32824-4887 | 2017-03-27 |
| 1891319075 | Melanie Marie Fyfe | Clinical Nurse Specialist | 12902 Usf Magnolia Dr, Tampa, FL 33612-9416 | 2020-06-03 |
| 1932567500 | Catherine Vesely | Clinical Nurse Specialist | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2016-02-10 |
| 1083897755 | Deborah Phipps Siegel | Clinical Nurse Specialist | 1700 S Tamiami Trl, Sarasota, FL 34239-3509 | 2007-12-17 |
| 1083770176 | Barbara J Ossorio | Clinical Nurse Specialist | 2900 12th St N, Naples, FL 34103-4528 | 2006-12-31 |
| 1962407395 | Daniel Joseph O'neal IIi | Clinical Nurse Specialist | 13000 Bruce B Downs Blvd, Tampa, FL 33612-4745 | 2005-06-14 |
| City | FORT MYERS |
| Zip Code | 33919 |
Please comment or provide details below to improve the information on JUDITH PETRIN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.