KELLY RAE PETTIGREW OPTICIAN LICENSE FL
NPI 1164917373
Optometrist in Dulce, NM

Q: What is Kelly Pettigrew's NPI number?

The NPI number for Kelly Pettigrew is 1164917373. It was assigned to this individual provider in the NPPES registry on June 29, 2018.

Q: What is Kelly Pettigrew's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Pettigrew was last updated on June 29, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 29, 2018

505 NORTH MUNDO, DULCE, NM 87528(575) 759-3291 Get Directions Write a Review

NPPES record last updated: June 29, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Kelly Rae Pettigrew Optician License Fl NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY RAE PETTIGREW OPTICIAN LICENSE FL (NPI 1164917373) is an individual optometrist in Dulce, New Mexico, licensed in Florida (DO5748) and active in the NPI registry since June 2018.

NPPES Registry Identity

NPI1164917373

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameKELLY RAE PETTIGREWCredential: OPTICIAN LICENSE FL

Location Address505 NORTH MUNDODulce, NM 87528

Mailing AddressPo Box 187Dulce, NM 87528-0187 · (575) 759-3291

Phone(575) 759-3291

Sole ProprietorNo

Enumeration DateJune 29, 2018

✔ NPI 1164917373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in FL · DO5748

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

505 NORTH MUNDO, Dulce, NM 87528

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Pettigrew's NPI number?

The NPI number for Kelly Pettigrew is 1164917373. It was assigned to this individual provider in the NPPES registry on June 29, 2018.

Where is Kelly Pettigrew located?

Kelly Pettigrew practices at 505 North Mundo, Dulce, NM 87528. The listed phone number is (575) 759-3291.

What is Kelly Pettigrew's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

When was this NPI record last updated?

The NPPES record for Kelly Pettigrew was last updated on June 29, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.