Provider Demographics
NPI:1255651634
Name:PEELE, NICOLA M (CMF)
Entity Type:Individual
Prefix:MRS
First Name:NICOLA
Middle Name:M
Last Name:PEELE
Suffix:
Gender:F
Credentials:CMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 AIRPORT RD
Mailing Address - Street 2:STE. 3
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1644
Mailing Address - Country:US
Mailing Address - Phone:252-233-2323
Mailing Address - Fax:252-233-0330
Practice Address - Street 1:101 AIRPORT RD
Practice Address - Street 2:STE. 3
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1644
Practice Address - Country:US
Practice Address - Phone:252-233-2323
Practice Address - Fax:252-233-0330
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC46925335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier