Provider Demographics
NPI:1861196503
Name:PECCHIO-BOWEN, CARLA ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:ELIZABETH
Last Name:PECCHIO-BOWEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9635 CHERRY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-8190
Mailing Address - Country:US
Mailing Address - Phone:330-720-8286
Mailing Address - Fax:
Practice Address - Street 1:9635 CHERRY HILLS DR
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-8190
Practice Address - Country:US
Practice Address - Phone:330-720-8286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide