Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Maria C Petty, NURSEPRACTITIONER

Individual provider Gerontology Nurse Practitioner · NPI 1114204419

Maria C Petty, NURSEPRACTITIONER is a Gerontology Nurse Practitioner in Willoughby, Ohio. Licensed in Connecticut, Massachusetts and Ohio. Registered with an NPI since 2011.

Licensed in
CT, MA, OH
In the registry since
2011
Specialties on file
3

Practice location Address checks out

35000 Kaiser Ct
Willoughby, OH 44094-3382
Phone: (440) 269-4600
Fax: (216) 229-6017
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence NP020610 (OH)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 004979 (CT)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence RN2290435 (MA)

Record details

NPI number1114204419
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedNovember 15, 2011
Last updated in NPPESJuly 8, 2021
Certification dateJuly 8, 2021

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