Provider Demographics
NPI:1043608441
Name:PECK, AMBER LYNNE (FNP-C)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNNE
Last Name:PECK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8588 SILVER MIST RUN
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:DE
Mailing Address - Zip Code:19968-3079
Mailing Address - Country:US
Mailing Address - Phone:302-228-8508
Mailing Address - Fax:
Practice Address - Street 1:1309 SAVANNAH RD STE B
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1514
Practice Address - Country:US
Practice Address - Phone:302-645-6698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-07
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL10032431163W00000X
DELG-0000827363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily