Provider Demographics
NPI:1083920870
Name:PETTIT, NANCE JANE (M'AC)
Entity Type:Individual
Prefix:
First Name:NANCE
Middle Name:JANE
Last Name:PETTIT
Suffix:
Gender:F
Credentials:M'AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 RED OAK RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-2328
Mailing Address - Country:US
Mailing Address - Phone:828-989-9275
Mailing Address - Fax:
Practice Address - Street 1:207 CHARLOTTE ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1415
Practice Address - Country:US
Practice Address - Phone:828-989-9275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC441171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist