Individual
MICHELLE PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4005 NW 21ST TER, GAINESVILLE, FL 32605-1714
(352) 213-5761
Mailing address
4005 NW 21ST TER, GAINESVILLE, FL 32605-1714
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 5213205
FL
Other
Enumeration date
02/03/2015
Last updated
04/14/2015
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