Provider Demographics
NPI:1952898157
Name:PEYTON, LEAH SHEPARDSON (NP)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:SHEPARDSON
Last Name:PEYTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8480 WINDSOR WALK LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-1802
Mailing Address - Country:US
Mailing Address - Phone:804-513-9702
Mailing Address - Fax:
Practice Address - Street 1:11814 KING WILLIAM RD
Practice Address - Street 2:
Practice Address - City:AYLETT
Practice Address - State:VA
Practice Address - Zip Code:23009-4103
Practice Address - Country:US
Practice Address - Phone:804-769-3022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176050363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily