Healthcare Provider Details

I. General information

NPI: 1649157520
Provider Name (Legal Business Name): ASHLEY NICOLE PEYTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2025
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1066 N POWER RD STE 101
MESA AZ
85205-5709
US

IV. Provider business mailing address

16816 S 14TH LN
PHOENIX AZ
85045-0758
US

V. Phone/Fax

Practice location:
  • Phone: 480-807-0130
  • Fax:
Mailing address:
  • Phone: 937-522-1688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number335454
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.419773
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: