Provider Demographics
NPI:1841817681
Name:PECHEK, JAMIE NICOLE (RN)
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:NICOLE
Last Name:PECHEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4088 HAMAILE LN
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-6829
Mailing Address - Country:US
Mailing Address - Phone:720-560-4997
Mailing Address - Fax:
Practice Address - Street 1:1 JARRETT WHITE RD BLDG 160
Practice Address - Street 2:
Practice Address - City:TRIPLER ARMY MEDICAL CENTER
Practice Address - State:HI
Practice Address - Zip Code:96859-5001
Practice Address - Country:US
Practice Address - Phone:808-433-5475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-27
Last Update Date:2020-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95162006163W00000X
HI71254163W00000X
CO174069163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse