Individual
MISS AMY LEIGH PESCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY STE 630, MILWAUKEE, WI 53215-5212
(414) 385-1922
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 385-1922
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
163851
WI
363L00000X
Nurse Practitioner
95004205
CA
363LA2100X
Acute Care Nurse Practitioner
95004205
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760837850
—
WI
Enumeration date
04/26/2016
Last updated
09/27/2023
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