Provider Demographics
NPI:1376166942
Name:PELTON, ASHLEIGH CLAIRE (LVN)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:CLAIRE
Last Name:PELTON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 E GLENDALE ST
Mailing Address - Street 2:
Mailing Address - City:MEXIA
Mailing Address - State:TX
Mailing Address - Zip Code:76667-3440
Mailing Address - Country:US
Mailing Address - Phone:254-747-3564
Mailing Address - Fax:
Practice Address - Street 1:1017 E GLENDALE ST
Practice Address - Street 2:
Practice Address - City:MEXIA
Practice Address - State:TX
Practice Address - Zip Code:76667-3440
Practice Address - Country:US
Practice Address - Phone:254-747-3564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX344639164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse