Provider Demographics
NPI:1942741939
Name:PEYTON, NICOLE (DC)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:
Last Name:PEYTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 36853
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-6853
Mailing Address - Country:US
Mailing Address - Phone:702-644-3333
Mailing Address - Fax:702-644-3336
Practice Address - Street 1:5270 W BASELINE RD STE 145
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-6959
Practice Address - Country:US
Practice Address - Phone:602-675-2843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-10
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8593111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor