Provider Demographics
NPI:1295801041
Name:PECHA, TRACY JUNE (RNBSN)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:JUNE
Last Name:PECHA
Suffix:
Gender:F
Credentials:RNBSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 DREXEL ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-4378
Mailing Address - Country:US
Mailing Address - Phone:402-294-4491
Mailing Address - Fax:402-232-5553
Practice Address - Street 1:2501 CAPEHART RD
Practice Address - Street 2:
Practice Address - City:OFFUTT A F B
Practice Address - State:NE
Practice Address - Zip Code:68113-1043
Practice Address - Country:US
Practice Address - Phone:402-294-6077
Practice Address - Fax:402-232-5553
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE57870163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics