MEDICARE: BRENDA PECK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	47031053541	MI

General Provider Information

NPI Number	:	1154704054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA PECK

Provider Business Mailing Address
First Line	:	18621 BLUE ISLAND CT
Second Line	:
City	:	ROSEVILLE
State	:	MI
Zip	:	48066-2938
Country	:	US
Telephone Number	:	313-243-6891
Fax Number	:

Provider Business Practice Location Address
First Line	:	18621 BLUE ISLAND CT
Second Line	:
City	:	ROSEVILLE
State	:	MI
Zip	:	48066-2938
Country	:	US
Telephone Number	:	313-243-6891
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2015
Last Update Date	:	07/09/2015

Similar Medicare Providers

1710749254 — WHITNEY LANEE SMITH FNP-C
Practice Location Address:

26390 GRATIOT AVE
ROSEVILLE, MI
48066-5106

Practice Phone: 586-221-7020
Practice Fax:

1932102308 — MICHAEL MOONEY, INC
Practice Location Address:

27700 GRATIOT AVE STE 202
ROSEVILLE, MI
48066-4880

Practice Phone: 586-350-6800
Practice Fax: 586-772-5102

1831191170 — OSAMA N NUNU MD
Practice Location Address:

25710 KELLY RD STE 1
ROSEVILLE, MI
48066-4959

Practice Phone: 586-772-2600
Practice Fax: 586-772-5289

1326040510 — DR. BASEM ALMASRI M.D.
Practice Location Address:

25710 KELLY RD , STE 3
ROSEVILLE, MI
48066-4959

Practice Phone: 586-772-2600
Practice Fax: 586-772-5289

1952305906 — MAXICARE HOME HEALTH AGENCY, INC
Practice Location Address:

28909 UTICA ROAD
ROSEVILLE, MI
48066

Practice Phone: 586-293-1600
Practice Fax: 586-293-1617

1194729053 — DR. DOUGLAS R MOORE D.O.
Practice Location Address:

25195 KELLY RD STE A
ROSEVILLE, MI
48066-4909

Practice Phone: 586-775-4594
Practice Fax: 586-775-4506

Directions to “ BRENDA PECK ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.