Individual
DEBORAH SUE PESHKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2902 BRADFORD ST NE, GRAND RAPIDS, MI 49525-6427
(616) 885-5200
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704118417
MI
363LA2200X
Adult Health Nurse Practitioner
4704118417
MI
Other
Enumeration date
01/12/2007
Last updated
10/01/2021
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