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NPI Code Detail

MEDICARE: VIKTORIA ELLEN PECK RN

MEDICARE:   VIKTORIA ELLEN PECK  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse317230OH

General Provider Information

NPI Number : 1063837862
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIKTORIA ELLEN PECK RN
Provider Business Mailing Address
First Line : 990 OAK LEA DR
Second Line :
City : TROY
State : OH
Zip : 45373-9536
Country : US
Telephone Number : 937-477-5230
Fax Number :
Provider Business Practice Location Address
First Line : 990 OAK LEA DR
Second Line :
City : TROY
State : OH
Zip : 45373-9536
Country : US
Telephone Number : 937-477-5230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2014
Last Update Date : 03/03/2014

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Directions to “ VIKTORIA ELLEN PECK RN” Practice Location

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