MEDICARE: LIUDMILA PECHERSKI NURSE PRACTITIONER

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	207Q00000X	Family Medicine Physician	227561	AZ
2	363LF0000X	Family Nurse Practitioner	RNP227561	AZ

General Provider Information

NPI Number	:	1821658584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIUDMILA PECHERSKI NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	1 NORTERRA DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85085-8204
Country	:	US
Telephone Number	:	602-607-3366
Fax Number	:	623-434-5052

Provider Business Practice Location Address
First Line	:	1 NORTERRA DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85085-8204
Country	:	US
Telephone Number	:	623-715-7055
Fax Number	:	623-434-5052

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

Provider Enumeration Date	:	06/15/2019
Last Update Date	:	07/15/2025

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Directions to “ LIUDMILA PECHERSKI NURSE PRACTITIONER” Practice Location

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