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General NPI Number Information
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NPI Number | 1063439750
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Entity Type | Organization
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Legal Business Name | PK HEALTH SERVICES LLC
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 4113 LITTLE RD UNIT 103
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655-1716
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Country | US
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Telephone | 727-376-2880
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Fax | 727-816-9745
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Provider Business Mailing Address
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Address Line | 4113 LITTLE RD UNIT 103
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655-1716
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Country | US
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Telephone | 727-376-2880
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Fax | 727-816-9745
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MS. DEBORAH LEE PIERCE
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Credential |
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Telephone | 727-376-2880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | ARNP1163702
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW4995
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License Number State | FL
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