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Individual

MS. EARLENE JANE PECKHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN,CPNP,MSN

Contact information

Practice address
191 FOUNTAIN ST, NEW HAVEN, CT 06515-1901
(203) 946-6606
(203) 946-6637
Mailing address
658 CHESTNUT RIDGE RD, ORANGE, CT 06477-2029
(203) 387-9967

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
000425
CT

Other

Enumeration date
07/10/2006
Last updated
07/08/2007
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