Individual
STASIA RENELL PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6255 INKSTER RD STE 307, GARDEN CITY, MI 48135-2538
(734) 458-3279
Mailing address
6255 INKSTER RD STE 307, GARDEN CITY, MI 48135-2538
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
4704300384
MI
363LG0600X
Gerontology Nurse Practitioner
Primary
4704300384
MI
Other
Enumeration date
01/15/2024
Last updated
05/15/2025
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