Individual
COREY E PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
389 FORGE RIDGE RD, HARROGATE, TN 37752-7730
(423) 869-5893
(423) 869-3574
Mailing address
PO BOX 10988, KNOXVILLE, TN 37939-0988
(865) 862-0998
(865) 544-1861
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
17687
TN
363LF0000X
Family Nurse Practitioner
3009879
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6015620
BCBS
TN
05
—
7100320540
—
KY
01
—
P01356284
MEDICARE RR
TN
05
—
Q006164
—
TN
Enumeration date
07/31/2013
Last updated
06/30/2016
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