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NPI Code Detail

MEDICARE: TERESA ANNE PECK CRNP

MEDICARE: TERESA ANNE PECK CRNP
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
1363L00000XNurse Practitioner1-1079730AL

General Provider Information

NPI Number : 1699847152
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA ANNE PECK CRNP
Provider Business Mailing Address
First Line : 73 WHITE BRIDGE RD # 103-243
Second Line :
City : NASHVILLE
State : TN
Zip : 37205-1444
Country : US
Telephone Number : 615-673-6737
Fax Number : 800-474-4039
Provider Business Practice Location Address
First Line : 6984 PINE FOREST RD
Second Line :
City : PENSACOLA
State : FL
Zip : 32526-8908
Country : US
Telephone Number : 615-673-6737
Fax Number : 800-474-4039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 09/11/2025

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