Doctor Name: | MRS. SONJA ELAINE PECKHAM |
NPI Number: | 1114201522 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNP |
License Number: | 12655NP |
Business Practice Address: | 7580 Auburn Rd Suite 207 Concord Twp, OH - 440779615 |
Business Phone Number: | 4403541802 |
Business Fax Number: | 4409536138 |
Mailing Address: | 7580 Auburn Rd, Suite 207 CONCORD TWP |
State: | OH |
Postal Code: | 440779615 |
Phone Number: | 4403541802 |
Fax Number: | 4409536138 |
NPI Enumeration Date: | 10/04/2011 |
NPI Last Update Date: | 10/04/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 12655NP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |