Individual
BRENDA PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
9250 AMBERTON PKWY, DALLAS, TX 75243-3224
(682) 236-3656
Mailing address
9250 AMBERTON PKWY, DALLAS, TX 75243-3224
(682) 236-3656
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP119849
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2035487-01
—
TX
05
—
2845448-02
—
TX
01
—
895N44
BCBS
TX
01
—
D07564
MEDICARE RR PALMETTO
TX
01
—
DQ5280
RR PALMETTO
TX
01
—
P00949091
PALMETTO RR
TX
Enumeration date
02/07/2011
Last updated
10/26/2020
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