Active NPI
Jenna Peck, APRN
- Women's Health Nurse Practitioner
- Gardnerville, NV
National Provider Identifier
1518471374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- APRN001863
- Practice address
- 1492 Hwy 395
#105
Gardnerville, NV 89410-8941 - Phone
- (775) 392-2802
- NPI assigned
- Nov 30, 2017
- Last updated
- Dec 22, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | APRN001863 | NV | Primary |
Addresses
Primary practice location
1492 Hwy 395
#105
Gardnerville, NV 89410-8941
Mailing address
1492 Hwy 395
#105
Gardnerville, NV 89410
Phone (775) 392-2802
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN001863 | NV | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608595200000",
"number": "1518471374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1492 HWY 395",
"address_2": "#105",
"city": "GARDNERVILLE",
"state": "NV",
"postal_code": "89410",
"telephone_number": "775-392-2802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1492 HWY 395",
"address_2": "#105",
"city": "GARDNERVILLE",
"state": "NV",
"postal_code": "894108941",
"telephone_number": "775-392-2802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECK",
"first_name": "JENNA",
"name_prefix": "Mrs.",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-30",
"last_updated": "2020-12-22",
"certification_date": "2020-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "NV",
"license": "APRN001863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardnerville, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.