LINDA JOYCE PETRUSICK (NPI# 1588846166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588846166 |
| Entity Type | Individual |
| Full Name | LINDA JOYCE PETRUSICK |
| Credential | NP |
| Practice Address |
57 Jessamine Street Georgetown SC 29442 |
| Mailing Address |
57 Jessamine Street Po Box 618 Georgetown SC 29442 |
| Practice Telephone | 8435468686 |
| Practice Fax Number | 8435461353 |
| Mailing Telephone | 8435468686 |
| Mailing Fax Number | 8435461353 |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2007-12-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
P2239 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
57 JESSAMINE STREET |
| City | GEORGETOWN |
| State | SC |
| Zip Code | 29442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902867252 | Kenneth Wesley Jordan | Chiropractor | 705 North Fraser St, Georgetown, SC 29442-0958 | 2006-03-28 |
| 1063583631 | Winyah Chiropractic Clinic Inc | Chiropractor | 2504 Highmarket St, Georgetown, SC 29442-1717 | 2006-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952901753 | Hq Dental Design | Clinic/Center | 3011 Dawn Dr Ste 105, Georgetown, TX 78628-2827 | 2020-10-29 |
| 1396345377 | Doris Donaway | Psychologist | 17 Merganser Rd Lot 95, Georgetown, DE 19947-9552 | 2020-10-28 |
| 1528668803 | Gwendolyn Marie Dicapo | Counselor | 207 S Elm St, Georgetown, TX 78626-5042 | 2020-10-27 |
| 1447850789 | Caitlin Brooke Callihan | Pharmacist | 1001 Cherry Blossom Way # Way7, Georgetown, KY 40324-9564 | 2020-10-27 |
| 1467051953 | Deontay Adrain Winchester | Counselor | 500 S Kaminski St Ste 213, Georgetown, SC 29440-3435 | 2020-10-26 |
| 1932709482 | Alexxis Nicole Warford | Counselor | 505 W University Ave Ste 105, Georgetown, TX 78626-6643 | 2020-10-26 |
| 1063011922 | Eden Alcoseba | Spec/Tech, Pathology | 2300 Wolf Ranch Pkwy Apt 6201, Georgetown, TX 78628-7299 | 2020-10-21 |
| 1124627286 | Kirsten Rene Parker | Chiropractor | 750 County Road 234 Bldg 1, Georgetown, TX 78633-4426 | 2020-10-20 |
| 1124626700 | Mind & Body Wellness | Nurse Practitioner | 105 Bob White Path, Georgetown, KY 40324-6169 | 2020-10-15 |
| 1740888742 | Bryan Hutchison | Counselor | 141 Mountain Valley St, Georgetown, TX 78628-2199 | 2020-10-12 |
| Find all providers in GEORGETOWN | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588175673 | Kristin Marie Alaniz | Nurse Practitioner | 2112 Sw H K Dodgen Loop, Suite 110, Georgetown, TX 78626 | 2017-10-17 |
| 1699067504 | Eliamar Herrera | Nurse Practitioner | 517 Tamara Dr, Georgetown, TX 78628-8828 | 2011-05-10 |
| 1831710458 | Christine Maire Black | Nurse Practitioner | 21141 Sterling Ave Unit 1, Georgetown, DE 19947-5571 | 2020-05-05 |
| 1366905655 | Emily Kate Jenkins | Nurse Practitioner | 435 Marina Dr, Georgetown, SC 29440-2410 | 2019-04-12 |
| 1528526928 | Raquel Limon | Nurse Practitioner | 600 High Tech Dr, Georgetown, TX 78626-8185 | 2019-03-05 |
| 1790255891 | Miranda Afsharirad | Nurse Practitioner | 600 High Tech Dr, Georgetown, TX 78626-8185 | 2018-11-30 |
| 1508332073 | Raquel Goytia | Nurse Practitioner | 600 High Tech Dr, Georgetown, TX 78626-8185 | 2018-10-22 |
| 1912382052 | Anna Newell | Nurse Practitioner | 57 Jessamine Ave, Georgetown, SC 29440-5837 | 2015-07-29 |
| 1295138998 | Emilye Kathryn Eggeling | Nurse Practitioner | 600 High Tech Dr, Georgetown, TX 78626-8185 | 2014-10-08 |
| 1780941807 | Rachel Matula | Nurse Practitioner | 600 High Tech Dr, Georgetown, TX 78626-8185 | 2012-04-13 |
| Find all providers in GEORGETOWN | ||||
| City | GEORGETOWN |
| Zip Code | 29442 |
Please comment or provide details below to improve the information on LINDA JOYCE PETRUSICK.
| 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.