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General NPI Number Information
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NPI Number | 1609218585
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Entity Type | Individual
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Provider Name | RACHEL ANN PECKHAM
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Gender | Female
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Dates
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Enumeration Date | 07/22/2013
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Last Update Date | 02/29/2024
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Provider Practice Location Address
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Address Line | 303 W ROSS ST
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City | TROY
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State | OH
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Zip | 45373-3931
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Country | US
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Telephone | 937-216-2501
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Fax |
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Provider Business Mailing Address
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Address Line | 1565 HAWK CIR APT C
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City | TROY
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State | OH
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Zip | 45373-4722
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Country | US
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Telephone | 937-216-2501
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | APRN.CNP.0035065
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN.147070-M-IV
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License Number State | OH
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