Provider Demographics
NPI:1639523707
Name:NALA PEELE
Entity Type:Organization
Organization Name:NALA PEELE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAREGIVER
Authorized Official - Prefix:
Authorized Official - First Name:NALA
Authorized Official - Middle Name:SIERRA
Authorized Official - Last Name:PEELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-749-5232
Mailing Address - Street 1:1270 GROVEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-3212
Mailing Address - Country:US
Mailing Address - Phone:614-749-5232
Mailing Address - Fax:
Practice Address - Street 1:1270 GROVEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-3212
Practice Address - Country:US
Practice Address - Phone:614-749-5232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========Medicaid