Provider Demographics
NPI:1003242082
Name:PETTIGREW, ANN M (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:M
Last Name:PETTIGREW
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4038 THOMAS NELSON HWY
Mailing Address - Street 2:
Mailing Address - City:ARRINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22922-2302
Mailing Address - Country:US
Mailing Address - Phone:434-263-4000
Mailing Address - Fax:434-263-4160
Practice Address - Street 1:4038 THOMAS NELSON HWY
Practice Address - Street 2:
Practice Address - City:ARRINGTON
Practice Address - State:VA
Practice Address - Zip Code:22922-2302
Practice Address - Country:US
Practice Address - Phone:434-263-4000
Practice Address - Fax:434-263-4160
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170963164W00000X
VA0001222660163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No163W00000XNursing Service ProvidersRegistered Nurse