Provider Demographics
NPI:1689365256
Name:VERESPEJ, PAYTON MAE
Entity Type:Individual
Prefix:
First Name:PAYTON
Middle Name:MAE
Last Name:VERESPEJ
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 1:360 SUMMERHILL DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-8015
Mailing Address - Country:US
Mailing Address - Phone:330-968-9982
Mailing Address - Fax:
Practice Address - Street 1:2084 EDENHALL DR
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-3828
Practice Address - Country:US
Practice Address - Phone:216-926-8525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker