Provider Demographics
NPI:1962763409
Name:PECK, JANET RAE (RN)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:RAE
Last Name:PECK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:PECK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:425 POPLAR DR
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-8466
Mailing Address - Country:US
Mailing Address - Phone:775-777-3246
Mailing Address - Fax:
Practice Address - Street 1:425 POPLAR DR
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-8466
Practice Address - Country:US
Practice Address - Phone:775-777-3246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN27243163W00000X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163W00000XNursing Service ProvidersRegistered Nurse