Provider Demographics
NPI:1558056762
Name:NEVIL, PEYTON COOPER
Entity Type:Individual
Prefix:
First Name:PEYTON
Middle Name:COOPER
Last Name:NEVIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:COLWICH
Mailing Address - State:KS
Mailing Address - Zip Code:67030-3008
Mailing Address - Country:US
Mailing Address - Phone:316-617-5487
Mailing Address - Fax:
Practice Address - Street 1:ONE MEMORIAL DRIVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68588
Practice Address - Country:US
Practice Address - Phone:316-617-5487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer