Provider Demographics
NPI:1609083013
Name:PEELOR, MARTHA C (RN, IBCLC)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:C
Last Name:PEELOR
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 PICKWICK DR
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1721
Mailing Address - Country:US
Mailing Address - Phone:412-831-0448
Mailing Address - Fax:412-831-0335
Practice Address - Street 1:103 PICKWICK DR
Practice Address - Street 2:
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1721
Practice Address - Country:US
Practice Address - Phone:412-831-0448
Practice Address - Fax:412-831-0335
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN320560L163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant