Individual
TINA PECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
430 S COMMERCE ST STE 300, WICHITA, KS 67202-4600
(316) 708-4099
(949) 209-5494
Mailing address
2250 N ROCK RD # 118-266, WICHITA, KS 67226-2331
(316) 708-4099
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-77614
KS
Other
Enumeration date
10/21/2020
Last updated
02/11/2021
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