Provider Demographics
NPI:1093787996
Name:PECK, ELIZABETH (FNP)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:PECK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-1504
Mailing Address - Country:US
Mailing Address - Phone:978-948-3902
Mailing Address - Fax:978-948-7530
Practice Address - Street 1:181 MAIN ST
Practice Address - Street 2:
Practice Address - City:ROWLEY
Practice Address - State:MA
Practice Address - Zip Code:01969-1504
Practice Address - Country:US
Practice Address - Phone:978-948-3902
Practice Address - Fax:978-948-7530
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA255664363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA93541OtherFALLON
MANP9676OtherBCBS
MA93541OtherFALLON
MANP5020Medicare ID - Type Unspecified