Provider Demographics
NPI:1023764305
Name:PEASPANEN, LORA NESSA
Entity type:Individual
Prefix:MRS
First Name:LORA
Middle Name:NESSA
Last Name:PEASPANEN
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 1:2801 C CT UNIT 1
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-4578
Mailing Address - Country:US
Mailing Address - Phone:440-998-0722
Mailing Address - Fax:
Practice Address - Street 1:2801 C CT UNIT 1
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-4578
Practice Address - Country:US
Practice Address - Phone:440-998-0722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator