Individual
MRS. BETTY JANE PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1203 MARKET AVE, JOHNSTON CITY, IL 62951-1842
(618) 525-5775
Mailing address
1203 MARKET AVE, JOHNSTON CITY, IL 62951-1842
(618) 525-5775
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043120069
IL
Other
Enumeration date
08/24/2018
Last updated
08/24/2018
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