Provider Demographics
NPI:1619080934
Name:PESCARO, DENISE (NP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:PESCARO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BRYAN SEARLE DR STE 456B
Mailing Address - Street 2:DUMC 3893
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-668-1748
Mailing Address - Fax:
Practice Address - Street 1:20 DUKE MEDICINE CIR
Practice Address - Street 2:DUKE CANCER CENTER CLINIC 2-2
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-668-1748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005605363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA199206OtherNP LICENSE
NC5005605OtherSTATE LICENSE
0298130-21OtherANCC CERTIFICATION
MP2630184OtherDEA