Provider Demographics
NPI:1740402627
Name:PISECHKO, CHERYL P (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:P
Last Name:PISECHKO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:CHERYL
Other - Middle Name:P
Other - Last Name:PISECHKO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:1562 TURK ROAD
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976
Mailing Address - Country:US
Mailing Address - Phone:215-343-5630
Mailing Address - Fax:
Practice Address - Street 1:2250 HICKORY ROAD
Practice Address - Street 2:SUITE 240
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462
Practice Address - Country:US
Practice Address - Phone:800-879-4471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN257102L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse