Individual
MRS. COURTNEY PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
5308 HARROUN RD # 285, SYLVANIA, OH 43560-2193
(419) 824-5633
(419) 824-5953
Mailing address
5308 HARROUN RD # 285, SYLVANIA, OH 43560-2193
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.004996RX
OH
363AM0700X
Medical Physician Assistant
50.004996RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0209103
—
OH
01
—
H487640
MEDICARE PIN
OH
Enumeration date
02/20/2017
Last updated
03/16/2026
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