Provider Demographics
NPI:1790264125
Name:WHITT, PAYTON HAILEY (STNA)
Entity Type:Individual
Prefix:MISS
First Name:PAYTON
Middle Name:HAILEY
Last Name:WHITT
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8652 STATE ROUTE 41
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:OH
Mailing Address - Zip Code:45101-9730
Mailing Address - Country:US
Mailing Address - Phone:606-375-9202
Mailing Address - Fax:
Practice Address - Street 1:8652 STATE ROUTE 41
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:OH
Practice Address - Zip Code:45101-9730
Practice Address - Country:US
Practice Address - Phone:606-375-9202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH321717240718376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty