Provider Demographics
NPI:1609465889
Name:PEEPLES, LADONNA SHUNTA
Entity Type:Individual
Prefix:
First Name:LADONNA
Middle Name:SHUNTA
Last Name:PEEPLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 ROGERS ST
Mailing Address - Street 2:
Mailing Address - City:ADEL
Mailing Address - State:GA
Mailing Address - Zip Code:31620-3627
Mailing Address - Country:US
Mailing Address - Phone:470-219-2080
Mailing Address - Fax:
Practice Address - Street 1:404 ROGERS ST
Practice Address - Street 2:
Practice Address - City:ADEL
Practice Address - State:GA
Practice Address - Zip Code:31620-3627
Practice Address - Country:US
Practice Address - Phone:470-219-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor