Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Katherine Marcela Pettyjohn, FNP-BC

Individual provider Primary Care Clinic/Center · NPI 1568945285

Mrs. Katherine Marcela Pettyjohn, FNP-BC is a Nurse Practitioner in Modesto, California. Qualified in 2018, 8 years ago. Practices with The Noble Group a Medical Corporation, a 3-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
8
Licensed in
CA
In the registry since
2018
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

1409 Lecourbe Ct
Modesto, CA 95356-8905
Phone: (209) 409-8239
Fax: (209) 409-8239
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X · Licence 95009952 (CA)

Record details

NPI number1568945285
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorYes
NPI enumeratedSeptember 9, 2018
Last updated in NPPESSeptember 9, 2018

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice The Noble Group A Medical Corporation — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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