Individual
LORI PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5551 WINGHAVEN BLVD, SUITE 240, O FALLON, MO 63368-3617
(636) 561-5561
(636) 561-5557
Mailing address
5551 WINGHAVEN BLVD, SUITE 240, O FALLON, MO 63368-3617
(636) 561-5561
(636) 561-5557
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2010022198
MO
Other
Enumeration date
11/18/2014
Last updated
11/18/2014
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