Provider Demographics
NPI:1194176859
Name:PEYTON, JANEA
Entity type:Individual
Prefix:
First Name:JANEA
Middle Name:
Last Name:PEYTON
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 1:9212 W RUSSELL RD
Mailing Address - Street 2:203
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1294
Mailing Address - Country:US
Mailing Address - Phone:702-937-4537
Mailing Address - Fax:
Practice Address - Street 1:9212 W RUSSELL RD
Practice Address - Street 2:203
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-1294
Practice Address - Country:US
Practice Address - Phone:702-937-4537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner