Individual
MS. NANCY JAMISON PECKENPAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED RD CDN CDE
Contact information
Practice address
1216 TRUMANSBURG ROAD, ITHACA, NY 14850-1314
(607) 272-1297
(607) 272-2366
Mailing address
1216 TRUMANSBURG ROAD, ITHACA, NY 14850-1314
(607) 272-1297
(607) 272-2366
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
0012301
NY
163WD0400X
Diabetes Educator Registered Nurse
09224400
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000916207001
HEALTH NOW INSURANCE CO
NY
01
—
204479481
BC/BS
NY
01
—
4410036
AETNA
NY
Enumeration date
04/10/2007
Last updated
12/07/2011
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