Provider Demographics
NPI:1538547195
Name:PEYTON, CIARA L
Entity type:Individual
Prefix:
First Name:CIARA
Middle Name:L
Last Name:PEYTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1456 E 204TH ST
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1402
Mailing Address - Country:US
Mailing Address - Phone:330-460-6041
Mailing Address - Fax:330-460-6042
Practice Address - Street 1:1456 E 204TH ST
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-1402
Practice Address - Country:US
Practice Address - Phone:330-460-6041
Practice Address - Fax:330-460-6042
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2384698251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health