Provider Demographics
NPI:1932700267
Name:CAIN, PEYTON ELIZABETH (RD)
Entity Type:Individual
Prefix:
First Name:PEYTON
Middle Name:ELIZABETH
Last Name:CAIN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9114 MILL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-4503
Mailing Address - Country:US
Mailing Address - Phone:913-982-7919
Mailing Address - Fax:
Practice Address - Street 1:1945 LAKEPOINTE DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-6424
Practice Address - Country:US
Practice Address - Phone:415-391-2141
Practice Address - Fax:415-989-9923
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN86153783133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered