Individual
ANDREA PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
701 W RUTH AVE, SALLISAW, OK 74955-7273
(918) 235-6622
Mailing address
701 W RUTH AVE, SALLISAW, OK 74955-7273
(918) 235-6622
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
222994
OK
Other
Enumeration date
05/22/2025
Last updated
05/22/2025
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