Individual
MARY KATHRYN PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2850 S INDUSTRIAL HWY, #75, ANN ARBOR, MI 48104-6796
(734) 677-1515
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704126433
MI
363LA2200X
Adult Health Nurse Practitioner
4704126433
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4704507
—
MI
Enumeration date
11/01/2006
Last updated
05/25/2017
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