Provider Demographics
NPI:1477170157
Name:PEONY HEALTH SERVICES
Entity Type:Organization
Organization Name:PEONY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HISAYI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:317-203-4441
Mailing Address - Street 1:438 S EMERSON AVE STE 164
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1948
Mailing Address - Country:US
Mailing Address - Phone:317-203-4441
Mailing Address - Fax:
Practice Address - Street 1:438 S EMERSON AVE STE 164
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1948
Practice Address - Country:US
Practice Address - Phone:317-203-4441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Multi-Specialty