Individual
CLETUS PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
4405 N. HOLLAND SYLVANIA RD., TOLEDO, OH 43623
(419) 517-0146
Mailing address
PO BOX 164, LUCKEY, OH 43443
(419) 309-1970
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.019586
OH
Other
Enumeration date
09/02/2016
Last updated
09/02/2016
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