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Individual
DR. PAYTON LEIGH TEN HAGEN
Active
Individual
DR. PAYTON LEIGH TEN HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP141860
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
402979501
—
TX
01
—
402979502
MEDICAID-CSHCN
TX
01
—
8LT680
BCBS
TX
Enumeration date
07/10/2019
Last updated
11/30/2019
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