Provider Demographics
NPI:1720697485
Name:PEYTON, NICOLE (RPH)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:
Last Name:PEYTON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 S MONROE ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-1529
Mailing Address - Country:US
Mailing Address - Phone:850-210-3958
Mailing Address - Fax:
Practice Address - Street 1:113 S MONROE ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-1529
Practice Address - Country:US
Practice Address - Phone:850-210-3958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS50858183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist