Provider Demographics
NPI:1760219554
Name:DISHONG, PAIGE ALEXIS
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:ALEXIS
Last Name:DISHONG
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 1:1634 HAMMOND AVE SW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44706-2848
Mailing Address - Country:US
Mailing Address - Phone:234-804-5760
Mailing Address - Fax:
Practice Address - Street 1:1634 HAMMOND AVE SW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44706-2848
Practice Address - Country:US
Practice Address - Phone:234-804-5760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No251J00000XAgenciesNursing Care