Healthcare Provider Details

I. General information

NPI: 1194762880
Provider Name (Legal Business Name): BETTINA PEYTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 PROSPECT STREET HOME HEALTH & HOSPICE
NASHUA NH
03060
US

IV. Provider business mailing address

16 BLOOD RD
HOLLIS NH
03049-6514
US

V. Phone/Fax

Practice location:
  • Phone: 603-882-2941
  • Fax:
Mailing address:
  • Phone: 603-882-2941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number56238
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: