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General NPI Number Information
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NPI Number | 1659470342
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Entity Type | Individual
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Provider Name | LIZA KIMBALL PECK NP
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Gender | Female
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 05/26/2017
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Provider Practice Location Address
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Address Line | 761 WORCESTER RD
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City | FRAMINGHAM
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State | MA
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Zip | 01701-5224
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Country | US
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Telephone | 508-872-1614
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Fax | 508-620-6572
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Provider Business Mailing Address
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Address Line | 761 WORCESTER RD
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City | FRAMINGHAM
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State | MA
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Zip | 01701-5224
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Country | US
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Telephone | 508-872-1614
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Fax | 508-620-6572
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN253707
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License Number State | MA
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