Individual
CARLA S PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, FNP-BC
Contact information
Practice address
5999 W MEMORY LN STE 1, GREENFIELD, IN 46140-7294
(317) 779-1204
(317) 940-5759
Mailing address
6572 W CHARLESTON WAY, MCCORDSVILLE, IN 46055-9677
(317) 407-6808
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28160871A
IN
363LF0000X
Family Nurse Practitioner
Primary
71004088A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
71004088A
IN
363LP2300X
Primary Care Nurse Practitioner
71004088A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000779844
ANTHEM
IN
01
—
000000791892
ANTHEM
IN
05
—
201085440
—
IN
05
—
300071854
—
IN
01
—
9360882
AETNA
IN
Enumeration date
05/11/2012
Last updated
04/25/2025
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