Provider Demographics
NPI:1720439458
Name:PEELE, NALA
Entity Type:Individual
Prefix:
First Name:NALA
Middle Name:
Last Name:PEELE
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 1:1270 GROVEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-3212
Mailing Address - Country:US
Mailing Address - Phone:614-972-0646
Mailing Address - Fax:
Practice Address - Street 1:1270 GROVEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207
Practice Address - Country:US
Practice Address - Phone:614-972-0646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker