Doctor Name: | MS. MELODY PECK FAUX |
NPI Number: | 1972700581 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | R046262 |
Business Practice Address: | 49 Hooper St Wiscasset, ME - 045784053 |
Business Phone Number: | 2078827911 |
Business Fax Number: | 2078826178 |
Mailing Address: | 49 Hooper St, WISCASSET |
State: | ME |
Postal Code: | 045784053 |
Phone Number: | 2078827911 |
Fax Number: | 2078826178 |
NPI Enumeration Date: | 06/27/2007 |
NPI Last Update Date: | 09/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R046262 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |