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General NPI Number Information
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NPI Number | 1225750458
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Entity Type | Organization
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Legal Business Name | PESH MEDICAL CONSULTING LLC
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Dates
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Enumeration Date | 09/14/2022
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 6150 CHERRY LN
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City | WISE
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State | VA
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Zip | 24293-4464
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Country | US
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Telephone | 276-337-0331
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Fax | 276-796-5707
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Provider Business Mailing Address
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Address Line | 6150 CHERRY LN
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City | WISE
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State | VA
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Zip | 24293-4464
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Country | US
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Telephone | 276-337-0331
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | PAULA HILL COLLINS
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Credential | DNP, FNP-BC
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Telephone | 276-337-0331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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