Provider Demographics
NPI:1093745895
Name:PEYTON, LORRIE D (FNP)
Entity Type:Individual
Prefix:
First Name:LORRIE
Middle Name:D
Last Name:PEYTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 HOFFMEYER RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-7311
Mailing Address - Country:US
Mailing Address - Phone:843-662-8182
Mailing Address - Fax:843-662-8183
Practice Address - Street 1:2410 HOFFMEYER RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-7311
Practice Address - Country:US
Practice Address - Phone:843-662-8182
Practice Address - Fax:843-662-8183
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2873363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC400514Medicaid
SC400514Medicaid