Provider Demographics
NPI:1871988642
Name:METZ, PEGGY DIANE
Entity type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:DIANE
Last Name:METZ
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 1:740 DEBBY LN E
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OH
Mailing Address - Zip Code:44906-1005
Mailing Address - Country:US
Mailing Address - Phone:419-610-4362
Mailing Address - Fax:
Practice Address - Street 1:740 DEBBY LN E
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OH
Practice Address - Zip Code:44906-1005
Practice Address - Country:US
Practice Address - Phone:419-610-4362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401477300113376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide