Provider Demographics
NPI:1770751133
Name:PESCH, NANCY (LLP, RN)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:PESCH
Suffix:
Gender:F
Credentials:LLP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30025 MUIRLAND DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2052
Mailing Address - Country:US
Mailing Address - Phone:248-421-2003
Mailing Address - Fax:248-421-2003
Practice Address - Street 1:30025 MUIRLAND DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2052
Practice Address - Country:US
Practice Address - Phone:248-421-2003
Practice Address - Fax:248-421-2003
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth