COLLEEN FLORA PETULLO NP-C
NPI 1790333003
Nurse Practitioner - Family in Prescott Valley, AZ

Q: What is Colleen Petullo's NPI number?

The NPI number for Colleen Petullo is 1790333003. It was assigned to this individual provider in the NPPES registry on August 29, 2019.

Q: What is Colleen Petullo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Colleen Petullo was last updated on December 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 August 29, 2019

9695 N. FIORELLA ST., PRESCOTT VALLEY, AZ 86315(702) 460-9009 Get Directions Write a Review

NPPES record last updated: December 9, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 9, 2020, Aug 29, 2019 (2 updates tracked since 2019).

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About Colleen Flora Petullo Np-c NPPES

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

COLLEEN FLORA PETULLO NP-C (NPI 1790333003) is an individual family provider in Prescott Valley, Arizona, licensed in Arizona (RNP227728) and active in the NPI registry since August 2019.

NPPES Registry Identity

NPI1790333003

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameCOLLEEN FLORA PETULLOCredential: NP-C

Location Address9695 N. FIORELLA ST.Prescott Valley, AZ 86315

Mailing Address9695 N. Fiorella St.Prescott Valley, AZ 86315 · (928) 312-2030

Phone(702) 460-9009

Sole ProprietorNo

Enumeration DateAugust 29, 2019

Last NPPES UpdateDecember 9, 20202 updates tracked since enumeration

NPPES CertifiedDecember 9, 2020

✔ NPI 1790333003 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in AZ · RNP227728✔ Licensed in NM · 59225

9695 N. FIORELLA ST., Prescott Valley, AZ 86315

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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 Colleen Petullo's NPI number?

The NPI number for Colleen Petullo is 1790333003. It was assigned to this individual provider in the NPPES registry on August 29, 2019.

Where is Colleen Petullo located?

Colleen Petullo practices at 9695 N. Fiorella St., Prescott Valley, AZ 86315. The listed phone number is (702) 460-9009.

What is Colleen Petullo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Colleen Petullo was last updated on December 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.