Provider Demographics
NPI:1164131587
Name:CECI, PEGGY (RN)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:CECI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 WESTCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-3902
Mailing Address - Country:US
Mailing Address - Phone:330-953-2550
Mailing Address - Fax:
Practice Address - Street 1:57 WESTCHESTER DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-3902
Practice Address - Country:US
Practice Address - Phone:330-953-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN227075163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2698237Medicaid
OH5002633OtherOHIO DODD