Individual
BETHANY IRENE PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-0816
(434) 294-0911
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024180276
VA
Other
Enumeration date
12/30/2020
Last updated
07/29/2021
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