Individual
MRS. JESSICA MARIE PECKHAM
Active
Individual
MRS. JESSICA MARIE PECKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
4704305491
MI
363LP2300X
Primary Care Nurse Practitioner
Primary
256861
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1715928
—
MI
Enumeration date
02/16/2018
Last updated
07/16/2026
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