Basic Information
| Provider Information | |||||||||
| NPI: | 1386364750 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PETTI | ||||||||
| FirstName: | ARIELLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 NEW HAMPSHIRE AVE STE 2 | ||||||||
| Address2: | |||||||||
| City: | PORTSMOUTH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038012864 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034106700 | ||||||||
| FaxNumber: | 3063198308 | ||||||||
| Practice Location | |||||||||
| Address1: | 29 STOREY AVE | ||||||||
| Address2: | |||||||||
| City: | NEWBURYPORT | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019501843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9782256607 | ||||||||
| FaxNumber: | 9782256609 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2022 | ||||||||
| LastUpdateDate: | 10/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WS0200X | RN2271630 | MA | N | Nursing Service Providers | Registered Nurse | School | 363L00000X | RN2271630 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | RN2271630 | 01 | MA | MASSACHUSETTS BOARD OF NURSING | OTHER |