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General NPI Number Information
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NPI Number | 1700040243
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Entity Type | Individual
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Provider Name | NANCY MARIE PECK RPH
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Gender | Female
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Dates
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Enumeration Date | 07/14/2008
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 1325 S. MILITARY TRAIL
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442
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Country | US
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Telephone | 954-428-7406
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Fax |
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Provider Business Mailing Address
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Address Line | 5702 NW 46TH DRIVE
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City | CORAL SPRINGS
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State | FL
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Zip | 33067
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Country | US
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Telephone | 954-753-3327
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | PS0029359
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License Number State | FL
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