Johanna C Pettrey (NPI# 1265413447, PAC ID# 9436208972) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1265413447 |
| PAC ID by PECOS | 9436208972 |
| Professional Enrollment ID | I20090513000022 |
| Full Name | Johanna C Pettrey |
| Organization Legal Name | CLOVIS FAMILY HEALTH CARE CENTER LLC |
| Address |
2301 N Dr Martin Luther King Jr Blvd Clovis NM 88101-9401 |
| Phone Number | 5757624455 |
| Gender | F |
| Medical School | GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2000 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 6002720455 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 320022 | PLAINS REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2301 N Dr Martin Luther King Jr Blvd, Clovis, NM 88101-9401 | 5757624455 | CLOVIS FAMILY HEALTH CARE CENTER LLC |
| 4100 High Resort Blvd Se, Rio Rancho, NM 87124-5901 | 5054628888 | PRESBYTERIAN HEALTHCARE SERVICES |
| 4100 High Resort Seblvd, Rio Rancho, NM 87124-5901 | 5054628800 | PRESBYTERIAN HEALTHCARE SERVICES |
| Organization Legal Name | CLOVIS FAMILY HEALTH CARE CENTER LLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Erika S Potts | Nurse Practitioner | Clovis Family Health Care Center LLC | 2301 N Dr Martin Luther King Jr Blvd, Clovis, NM 88101-9401 |
| Kim G Devou | Nurse Practitioner | Clovis Family Health Care Center LLC | 2301 N Dr Martin Luther King Jr Blvd, Clovis, NM 88101-9401 |
| Street Address |
2301 N DR MARTIN LUTHER KING JR BLVD |
| City | CLOVIS |
| State | NM |
| Zip | 88101-9401 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jon M Shrader | Family Medicine | 2301 N Dr Martin Luther King Jr Blvd, Clovis, NM 88101-9401 | |
| Erika S Potts | Nurse Practitioner | Clovis Family Health Care Center LLC | 2301 N Dr Martin Luther King Jr Blvd, Clovis, NM 88101-9401 |
| Kim G Devou | Nurse Practitioner | Clovis Family Health Care Center LLC | 2301 N Dr Martin Luther King Jr Blvd, Clovis, NM 88101-9401 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Vanessa Yardley | Certified Registered Nurse Anesthetist (crna) | Anesthesia Associates of New Mexico P C | Plains Regional Medical Ctr, 2100 N. Martin Luther King Jr. Blvd, Clovis, NM 88101 |
| Jared Dumas | Certified Registered Nurse Anesthetist (crna) | Anesthesia Associates of New Mexico P C | Plains Regional Medical Ctr, 2100 N. Martin Luther King Jr. Blvd, Clovis, NM 88101 |
| Ryan Steed | Certified Registered Nurse Anesthetist (crna) | Anesthesia Associates of New Mexico P C | Plains Regional Medical Ctr, 2100 N. Martin Luther King Jr. Blvd, Clovis, NM 88101 |
| Ndeye Ndour | Certified Registered Nurse Anesthetist (crna) | Anesthesia Associates of New Mexico P C | Plains Regional Medical Ctr, 2100 N. Martin Luther King Jr. Blvd, Clovis, NM 88101 |
| Jacob T Russell | Certified Registered Nurse Anesthetist (crna) | Anesthesia Associates of New Mexico P C | Plains Regional Medical Ctr, 2100 N. Martin Luther King Jr. Blvd, Clovis, NM 88101 |
| Aba Saaba Hagan | Nurse Practitioner | Presbyterian Healthcare Services | 2200 W 21st St, Plains Regional Medical Group, Clovis, NM 88101-2011 |
| Donna M Thibodeau | Internal Medicine | Presbyterian Healthcare Services | 2200 W 21st St, Plains Regional Medical Group, Clovis, NM 88101-2011 |
| Kalyan Chakravarthy Saginala | Internal Medicine | Presbyterian Healthcare Services | 2200 W 21st St, Plains Regional Medical Group, Clovis, NM 88101-2011 |
| Lorena A Kroeger | Nurse Practitioner | Presbyterian Healthcare Services | 2200 W 21st St, Plains Regional Medical Group, Clovis, NM 88101-2011 |
| Brian E Willmon | Internal Medicine | Presbyterian Healthcare Services | 2200 W 21st St, Plains Regional Medical Group, Clovis, NM 88101-2011 |
| Find all physicians in zip 88101 | |||
| City | CLOVIS |
| Zip Code | 88101 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | CLOVIS + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Johanna C Pettrey.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.