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

Mrs. Johanna Christine Pettrey, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1265413447

Mrs. Johanna Christine Pettrey, FNP-BC is a Nurse Practitioner in Portales, New Mexico. Qualified in 2000, 26 years ago. Practices with La Casa De Buena Salud Inc, a 2-clinician group and accepts Medicare assignment. Licensed in New Mexico and Virginia.

Years since qualifying
26
Licensed in
NM, VA
In the registry since
2005
Specialties on file
3
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

1515 W Fir St
Portales, NM 88130-5703
Phone: (575) 356-6695
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence CNP01151 (NM)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence R47083 (NM)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 0001144582 (VA)

Record details

NPI number1265413447
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedNovember 7, 2005
Last updated in NPPESApril 24, 2024
Certification dateApril 24, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice La Casa De Buena Salud Inc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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